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Evaluation of three dimensional conformal radiation therapy of oesophageal cancer: a dosimetric study

Published online by Cambridge University Press:  05 December 2018

Hafiz Muhibb ullah Zulkafal ,
Muhammad Mazhar Iqbal ,
Muhammad Waqas Akhtar ,
Khalid Iqbal  and
Muhammad Afzal Khan
Hafiz Muhibb ullah Zulkafal*
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Pakistan Nishtar Medical University Multan, Pakistan
Muhammad Mazhar Iqbal
Affiliation:
Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research CentreLahore, Pakistan
Muhammad Waqas Akhtar
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Pakistan
Khalid Iqbal
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Pakistan Nishtar Medical University Multan, Pakistan
Muhammad Afzal Khan
Affiliation:
Department of Physics, The Islamia University of Bahawalpur, Pakistan
*
Author for correspondence: Hafiz Muhibb ullah Zulkafal, Department of Physics, The Islamia University of Bahawalpur, Pakistan. Tel: +92-3024388245; E-mail: muhibbiub@yahoo.com
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Abstract

Aims

The main objective of this research work is to compare the dosimertic effect on lower and upper oesophagus cancer treatment using 3D conformal radiotherapy as well as to evaluate the doses administered to the organs at risk.

Materials and methods

In this study, a cohort of 30 oesophageal cancer patients between the ages of 45 and 67 years registered during March 2017 to February 2018 was considered. These patients were treated through 3D conformal radiotherapy using four-field technique. Beam energy of 15 MV from Varian DHX linear accelerator was used. The given 30 patients were divided into two groups. The 1st group of 15 patients with upper oesophagus cancer was prescribed 5000 cGy doses, and the 2nd group of remaining 15 patients with lower oesophagus cancer was prescribed 4500 cGy. Computed tomography scans of every patient were obtained and then transmitted to Eclipse TPS for generating treatment plans. All radiotherapy plans were evaluated through various dosimetric indices. Statistical analysis software SPSS was utilised to get the values of means standard error and standard deviation of these indices for the treatment plan evaluation.

Results

Uniformity index (UI) calculated for first group of patients showed difference of 7·4% from ideal value. A difference of 7% between ideal and calculated UI value was observed in 2nd group of patients. The values of other dosimetric indices like coverage, homogeneity, moderate dose homogeneity index (mDHI) and radical dose homogeneity index (rDHI) were found in limits specified by the Radiation Therapy and Oncology Group. The maximum difference of 6% was observed between the coverage mean values of 1st and 2nd group treatment plans.

Conclusion

For oesophageal cancer, 3D conformal radiotherapy using four-field treatment plans shows homogeneous distribution of dose around the target and limits the dose to organ at risk.

Keywords

AP-PA dose deliverydose distributiondose verificationindices in radiotherapyoesophageal cancer
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 3 , September 2019 , pp. 246 - 250
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Zulkafal HMu, Iqbal MM, Akhtar MW, Iqbal K, Khan MA. (2019) Evaluation of three dimensional conformal radiation therapy of oesophageal cancer: a dosimetric study. Journal of Radiotherapy in Practice18: 246–250. doi: 10.1017/S1460396918000663

References

1. Nakagawa, S, Kanda, T, Kosugi, S I, Ohashi, M, Suzuki, T, Hatakeyama, K. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg 2004; 198(2): 205–211.10.1016/j.jamcollsurg.2003.10.005Google Scholar
2. Huizinga, J D, Lammers, W J. Gut peristalsis is governed by a multitude of cooperating mechanisms. Am J Physiol Gastrointest Liver Physiol 2009; 296(1): G1–G8.10.1152/ajpgi.90380.2008Google Scholar
3. Zhang, Y. Epidemiology of esophageal cancer. World J Gastroenterol 2013; 19(34): 5598.10.3748/wjg.v19.i34.5598Google Scholar
4. Torre, L A, Bray, F, Siegel, R L, Ferlay, J, Lortet-Tieulent, J, Jemal, A. Global cancer statistics, 2012. CA: A Cancer J Clin 2015; 65(2): 87–108.Google Scholar
5. Herskovic, A, Leichman, L, Lattin, P et al. Chemo/radiation with and without surgery in the thoracic esophagus: the Wayne State experience. Int J Radiat Oncol Biol Phys 1988; 15(3): 655–662.10.1016/0360-3016(88)90308-2Google Scholar
6. Forastiere, A A, Orringer, M B, Perez-Tamayo, C, Urba, S G, Zahurak, M. Preoperative chemoradiation followed by transhiatal esophagectomy for carcinoma of the esophagus. J Clin Oncol 1993; 11(6): 1118–1123.10.1200/JCO.1993.11.6.1118Google Scholar
7. Kocher, H M, Tekkis, P P, Knisley, J P S. Surgical treatment of esophageal cancer. N Engl J Med 2003; 348: 1177–1179.Google Scholar
8. Xiao, Z F, Yang, Z Y, Liang, J et al. Value of radiotherapy after radical surgery for esophageal carcinoma: a report of 495 patients. Ann Thorac Surg 2003; 75(2): 331–336.10.1016/S0003-4975(02)04401-6Google Scholar
9. Minsky, B D, Pajak, T F, Ginsberg, R J et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 2002; 20(5): 1167–1174.10.1200/JCO.2002.20.5.1167Google Scholar
10. Xiao, Z F, Yang, Z Y, Miao, Y J et al. Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: report of 549 cases. Int J Radiat Oncol Biol Phys 2005; 62(1): 82–90.10.1016/j.ijrobp.2004.08.046Google Scholar
11. Minsky, B D, Pajak, T F, Ginsberg, R J et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol 2002; 20(5): 1167–1174.10.1200/JCO.2002.20.5.1167Google Scholar
12. Liu, H, Qi, B, Guo, X, Tang, L Q et al. Genetic variations in radiation and chemotherapy drug action pathways and survival in locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. PloS one 2013; 8(12): e82750.10.1371/journal.pone.0082750Google Scholar
13. Hancock, S L, Glatstein, E. Radiation therapy of esophageal cancer. Semin Oncol 1984; 11 (2): 144–158.Google Scholar
14. Shridhar, R, Almhanna, K, Meredith, K L et al. Radiation therapy and esophageal cancer. Cancer Control 2013; 20(2): 97–110.10.1177/107327481302000203Google Scholar
15. Nayan, N, Bhattacharyya, M, Jagtap, V K, Kalita, A K, Sunku, R, Roy, P S. Standard-dose versus high-dose radiotherapy with concurrent chemotherapy in esophageal cancer: A prospective randomized study. South Asian J Cancer 2018; 7(1): 27–30.Google Scholar
16. Suh, Y G, Lee, I J, Koom, W S et al. High-dose versus standard-dose radiotherapy with concurrent chemotherapy in stages II–III esophageal cancer. Jpn J Clin Oncol 2014; 44(6): 534–540.10.1093/jjco/hyu047Google Scholar
17. Gulia, A, Patel, F, Rai, B, Bansal, A, Sharma, S C. Conventional four field radiotherapy versus computed tomography-based treatment planning in cancer cervix: a dosimetric study. South Asian J Cancer 2013; 2(3): 132–135.10.4103/2278-330X.114116Google Scholar
18. Zulkafal, H M, Khan, M A, Ahmad, M W, Akram, M, Buzdar, S A, Iqbal, K. Volumetric modulated arc therapy treatment planning assessment for low-risk prostate cancer in radiotherapy. Clin Cancer Investig J 2017; 6(4): 179–183.10.4103/ccij.ccij_38_17Google Scholar
19. Kataria, T, Sharma, K, Subramani, V, Karrthick, K P, Bisht, S S. Homogeneity index: an objective tool for assessment of conformal radiation treatments. J Med Phys 2012; 37(4): 207–213.10.4103/0971-6203.103606Google Scholar
20. Agostinelli, S, Garelli, S, Gusinu, M et al. Dosimetric analysis of Tomotherapy-based intracranial stereotactic radiosurgery of brain metastasis. Phys Medica 2018; 52: 48–55.10.1016/j.ejmp.2018.06.632Google Scholar
21. Iqbal, K, Isa, M, Buzdar, S A, Gifford, K A, Afzal, M. Treatment planning evaluation of sliding window and multiple static segments technique in intensity modulated radiotherapy. Rep Pract Oncol Radiother 2013; 18(2): 101–106.10.1016/j.rpor.2012.10.003Google Scholar
22. Feuvret, L, Noël, G, Mazeron, J J, Bey, P. Conformity index: a review. Int J Radiat Oncol Biol Phys 2006; 64(2): 333–342.10.1016/j.ijrobp.2005.09.028Google Scholar
23. Eisenberg, B L, Harris, J, Blanke, C D et al. Phase II trial of neoadjuvant/adjuvant imatinibmesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST): early results of RTOG 0132/ACRIN 6665. J Surg Oncol 2009; 99(1): 42–47.10.1002/jso.21160Google Scholar