Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지
DOI QR코드

DOI QR Code

Influence of jaw tracking in intensity-modulated and volumetric-modulated arc radiotherapy for head and neck cancers: a dosimetric study

  • Mani, Karthick Raj (Research and Development Centre, Bharathiar University) ;
  • Upadhayay, Sagar (Radiation Oncology, Kathmandu Cancer Center) ;
  • Das, K.J. Maria (Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences)
  • Received : 2016.12.29
  • Accepted : 2017.02.22
  • Published : 2017.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To Study the dosimetric advantage of the Jaw tracking technique in intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) for Head and Neck Cancers. Materials and Methods: We retrospectively selected 10 previously treated head and neck cancer patients stage (T1/T2, N1, M0) in this study. All the patients were planned for IMRT and VMAT with simultaneous integrated boost technique. IMRT and VMAT plans were performed with jaw tracking (JT) and with static jaw (SJ) technique by keeping the same constraints and priorities for a particular patient. Target conformity, dose to the critical structures and low dose volumes were recorded and analyzed for IMRT and VMAT plans with and without JT for all the patients. Results: The conformity index average of all patients followed by standard deviation (${\bar{x}}{\pm}{\sigma}_{\bar{x}}$) of the JT-IMRT, SJ-IMRT, JT-VMAT, and SJ-VMAT were $1.72{\pm}0.56$, $1.67{\pm}0.57$, $1.83{\pm}0.65$, and $1.85{\pm}0.64$, and homogeneity index were $0.059{\pm}0.05$, $0.064{\pm}0.05$, $0.064{\pm}0.04$, and $0.064{\pm}0.05$. JT-IMRT shows significant mean reduction in right parotid and left parotid shows of 7.64% (p < 0.001) and 7.45% (p < 0.001) compare to SJ-IMRT. JT-IMRT plans also shows considerable dose reduction to thyroid, inferior constrictors, spinal cord and brainstem compared to the SJ-IMRT plans. Conclusion: Significant dose reductions were observed for critical structure in the JT-IMRT compared to SJ-IMRT technique. In JT-VMAT plans dose reduction to the critical structure were not significant compared to the SJ-IMRT due to relatively lesser monitor units.

Keywords

References

  1. Lee N, Puri DR, Blanco AI, Chao KS. Intensity-modulated radiation therapy in head and neck cancers: an update. Head Neck 2007;29:387-400. https://doi.org/10.1002/hed.20332
  2. Ng J, Shuryak I. Minimizing second cancer risk following radiotherapy: current perspectives. Cancer Manag Res 2014;7:1-11.
  3. LoSasso T, Chui CS, Ling CC. Physical and dosimetric aspects of a multileaf collimation system used in the dynamic mode for implementing intensity modulated radiotherapy. Med Phys 1998;25:1919-27. https://doi.org/10.1118/1.598381
  4. Cadman P, McNutt T, Bzdusek K. Validation of physics improvements for IMRT with a commercial treatmentplanning system. J Appl Clin Med Phys 2005;6:74-86. https://doi.org/10.1120/jacmp.v6i2.2083
  5. Feng Z, Wu H, Zhang Y, Zhang Y, Cheng J, Su X. Dosimetric comparison between jaw tracking and static jaw techniques in intensity-modulated radiotherapy. Radiat Oncol 2015;10:28. https://doi.org/10.1186/s13014-015-0329-4
  6. International Commission on Radiation Units and Measurements. Prescribing, recording, and reporting photonbeam intensity-modulated radiation therapy (IMRT): contents (ICRU Report 83). J ICRU 2010;10:NP.
  7. Snyder KC, Wen N, Huang Y, et al. Use of jaw tracking in intensity modulated and volumetric modulated arc radiation therapy for spine stereotactic radiosurgery. Pract Radiat Oncol 2015;5:e155-62. https://doi.org/10.1016/j.prro.2014.09.002
  8. Joy S, Starkschall G, Kry S, et al. Dosimetric effects of jaw tracking in step-and-shoot intensity-modulated radiation therapy. J Appl Clin Med Phys 2012;13:136-45. https://doi.org/10.1120/jacmp.v13i2.3707
  9. Kim JI, Park JM, Park SY, Choi CH, Wu HG, Ye SJ. Assessment of potential jaw-tracking advantage using control point sequences of VMAT planning. J Appl Clin Med Phys 2014;15:160-8.
  10. Schmidhalter D, Fix MK, Niederer P, Mini R, Manser P. Leaf transmission reduction using moving jaws for dynamic MLC IMRT. Med Phys 2007;34:3674-87. https://doi.org/10.1118/1.2768864
  11. Lee CC, Wu A, Garg M, et al. A new approach to reduce number of split fields in large field IMRT. Med Dosim 2011;36:1-5. https://doi.org/10.1016/j.meddos.2009.10.001
  12. Chao KS, Deasy JO, Markman J, et al. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys 2001;49:907-16. https://doi.org/10.1016/S0360-3016(00)01441-3
  13. Trotti A. Toxicity in head and neck cancer: a review of trends and issues. Int J Radiat Oncol Biol Phys 2000;47:1-12. https://doi.org/10.1016/S0360-3016(99)00558-1

Cited by

  1. Assessment of the modulation degrees of intensity-modulated radiation therapy plans vol.13, pp.1, 2018, https://doi.org/10.1186/s13014-018-1193-9
  2. Dosimetric Comparison Between Jaw Tracking and No Jaw Tracking in Intensity-Modulated Radiation Therapy vol.18, pp.None, 2019, https://doi.org/10.1177/1533033819841061
  3. A 3D-printed patient-specific applicator guide for use in high-dose-rate interstitial brachytherapy for tongue cancer: a phantom study vol.64, pp.13, 2017, https://doi.org/10.1088/1361-6560/ab277e
  4. Development of an Assemblable, Daily, Quality-Assurance Device for Line-Scanning Proton Therapy vol.75, pp.4, 2017, https://doi.org/10.3938/jkps.75.344
  5. Dosimetric comparison of jaw tracking in intensity modulated and volumetric modulated arc radiotherapy for carcinoma of cervix vol.25, pp.3, 2017, https://doi.org/10.2478/pjmpe-2019-0021
  6. Comparison of O-ring and General Linacs for Treatment Planning of Volumetric Modulated Arc Therapy vol.76, pp.4, 2017, https://doi.org/10.6009/jjrt.2020_jsrt_76.4.339
  7. The use of collimator angle optimization and jaw tracking for VMAT‐based single‐isocenter multiple‐target stereotactic radiosurgery for up to six targets in the Varian Eclipse tre vol.22, pp.9, 2017, https://doi.org/10.1002/acm2.13360
  8. Comparison of combinations of irradiation techniques and jaw conditions in intensity‐modulated radiotherapy for lung cancer vol.22, pp.10, 2017, https://doi.org/10.1002/acm2.13416