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Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept.
- Source :
-
Physics and imaging in radiation oncology [Phys Imaging Radiat Oncol] 2021 Nov 10; Vol. 20, pp. 76-81. Date of Electronic Publication: 2021 Nov 10 (Print Publication: 2021). - Publication Year :
- 2021
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Abstract
- Background and Purpose: Conventional elective neck irradiation (ENI) in head and neck cancer consists of radiotherapy (RT) to the regional lymph node (LN) levels contoured on computed tomography. Hybrid Magnetic Resonance (MR) - RT modalities, such as combined magnetic resonance imaging - linear accelerators (MRLs), might enable new ENI strategies in which individual non-suspect lymph nodes (i-LNs) are targeted. In this treatment planning study, new MR-based strategies targeting i-LNs (i-ENI) were compared to conventional treatment.<br />Materials and Methods: All i-LNs were delineated on MR images of ten retrospectively selected patients with T2-4aN0M0 laryngeal cancer. Three strategies were considered. Strategy A: Conventional ENI delivered with a conventional linear accelerator (35x 1.55 Gy). Strategy B: MRL-based i-ENI (35x 1.55 Gy) to the individual lymph nodes including a background dose to the conventional elective neck volumes (35x 1.03 Gy). Strategy C: Same as Strategy B, but without background dose. In all plans the dose prescription to the primary tumor was 35x 2 Gy. Mean dose ( D <subscript>mean</subscript> ) reductions in the organs at risk (OAR) were compared using the Wilcoxon signed rank test.<br />Results: Compared to conventional ENI (strategy A), significant D <subscript>mean</subscript> reductions of 6.0 Gy and 8.0 Gy were observed in the submandibular glands, of 9.4 Gy and 13 Gy in the carotid arteries and of 9.9 Gy and 19.4 Gy in the thyroid for strategy B and C, respectively. Large inter-patient variations of D <subscript>mean</subscript> reductions were observed in all OARs.<br />Conclusion: MRL-based i-ENI is a new promising concept that could reduce the mean dose to OARs in the neck significantly for patients with laryngeal cancer.<br />Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (© 2021 The Author(s).)
Details
- Language :
- English
- ISSN :
- 2405-6316
- Volume :
- 20
- Database :
- MEDLINE
- Journal :
- Physics and imaging in radiation oncology
- Publication Type :
- Academic Journal
- Accession number :
- 35169639
- Full Text :
- https://doi.org/10.1016/j.phro.2021.10.006