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Dosimetric comparison of intensity-modulated radiation therapy (IMRT) and field-in-field (FIF) technique for head-and-neck cancer

Published online by Cambridge University Press:  20 November 2020

Nguyen Thi Lan ,
Hoang Dai Viet ,
Duong Thanh Tai Open the ORCID record for Duong Thanh Tai [Opens in a new window]  and
James C. L. Chow
Nguyen Thi Lan
Affiliation:
Department of Radiotherapy and Nuclear Medicine, Radiation Oncology Center, Baichay Hospital, Quang Ninh, Vietnam
Hoang Dai Viet
Affiliation:
Department of Radiotherapy and Nuclear Medicine, Radiation Oncology Center, Baichay Hospital, Quang Ninh, Vietnam
Duong Thanh Tai*
Affiliation:
Department of Industrial Electronics and Biomedical Engineering, HCMC University of Technology and Education, Ho Chi Minh, Vietnam
James C. L. Chow
Affiliation:
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada Department of Physics, Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
*
Author for correspondence: Duong Thanh Tai, Department of Industrial Electronics and Biomedical Engineering, Faculty of Electrical and Electronic Engineering, Ho Chi Minh City University of Technology and Education, 01 Vo Van Ngan Street, Thu Duc District, Ho Chi Minh, Vietnam. Tel: +84 945569139. E-mails: taidt@hcmute.edu.vn; thanhtaiphys@gmail.com
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Abstract

Purpose:

This study compared the plan dosimetry between the intensity-modulated radiation therapy (IMRT) and field-in-field (FIF) technique for head-and-neck cancer using the Elekta Monaco treatment planning system (TPS).

Materials and methods:

A total of 20 head-and-neck cancer patients were selected in this study. IMRT and FIF plans for the patients were created on the Monaco TPS (ver. 5.11.02) using the 6-MV photon beam generated by the Elekta Synergy linear accelerator. The dose–volume histograms, maximum doses, minimum doses, mean doses of the target volumes and organs-at-risk (OARs), conformity index (CI), homogeneity index (HI) and monitor units (MUs) were determined for each IMRT and FIF plan. All IMRT plans passed the patient-specific quality assurance tests from the 2D diode array measurements (MatriXX Evolution System, IBA Dosimetry, Germany).

Results:

The results showed that the dose distribution to the target volumes of IMRT plans was better than FIF plans, while the dose (mean or max dose) to the OAR was significantly lower than FIF plan, respectively. IMRT and FIF resulted in planning target volume coverage with mean dose of 71·32 ± 0·76 and 73·12 ± 0·62 Gy, respectively, and HI values of 0·08 ± 0·01 (IMRT) and 0·19 ± 0·06 (FIF). The CI for IMRT was 0·98 ± 0·01 and FIF was 0·97 ± 0·01. For the spinal cord tolerance (maximum dose < 45 Gy), IMRT resulted in 39·85 ± 2·04 Gy compared to 41·37 ± 2·42 Gy for FIF. In addition, the mean doses to the parotid grand were 27·27 ± 7·48 and 48·68 ± 1·62 Gy for the IMRT and FIF plans, respectively. Significantly more MUs were required in IMRT plans than FIF plans (on average, 846 ± 100 MU in IMRT and 467 ± 41 MU in FIF).

Conclusions:

It is concluded that the IMRT technique could provide a better plan dosimetry than the FIF technique for head-and-neck patients.

Keywords

Field-in-field (FIF)intensity-modulated radiation therapy (IMRT)treatment planning
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 153 - 158
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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