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Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get?

Publication ,  Journal Article
O'Daniel, JC; Garden, AS; Schwartz, DL; Wang, H; Ang, KK; Ahamad, A; Rosenthal, DI; Morrison, WH; Asper, JA; Zhang, L; Tung, S-M; Mohan, R; Dong, L
Published in: Int J Radiat Oncol Biol Phys
November 15, 2007

PURPOSE: To quantify the differences between planned and delivered parotid gland and target doses, and to assess the benefits of daily bone alignment for head and neck cancer patients treated with intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: Eleven head and neck cancer patients received two CT scans per week with an in-room CT scanner over the course of their radiotherapy. The clinical IMRT plans, designed with 3-mm to 4-mm planning margins, were recalculated on the repeat CT images. The plans were aligned using the actual treatment isocenter marked with radiopaque markers (BB) and bone alignment to the cervical vertebrae to simulate image-guided setup. In-house deformable image registration software was used to map daily dose distributions to the original treatment plan and to calculate a cumulative delivered dose distribution for each patient. RESULTS: Using conventional BB alignment led to increases in the parotid gland mean dose above the planned dose by 5 to 7 Gy in 45% of the patients (median, 3.0 Gy ipsilateral, p = 0.026; median, 1.0 Gy contralateral, p = 0.016). Use of bone alignment led to reductions relative to BB alignment in 91% of patients (median, 2 Gy; range, 0.3-8.3 Gy; 15 of 22 parotids improved). However, the parotid dose from bone alignment was still greater than planned (median, 1.0 Gy, p = 0.007). Neither approach affected tumor dose coverage. CONCLUSIONS: With conventional BB alignment, the parotid gland mean dose was significantly increased above the planned mean dose. Using daily bone alignment reduced the parotid dose compared with BB alignment in almost all patients. A 3- to 4-mm planning margin was adequate for tumor dose coverage.

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Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

November 15, 2007

Volume

69

Issue

4

Start / End Page

1290 / 1296

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Spinal Cord
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Prostheses and Implants
  • Parotid Gland
  • Oncology & Carcinogenesis
  • Movement
  • Humans
 

Citation

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O’Daniel, J. C., Garden, A. S., Schwartz, D. L., Wang, H., Ang, K. K., Ahamad, A., … Dong, L. (2007). Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get? Int J Radiat Oncol Biol Phys, 69(4), 1290–1296. https://doi.org/10.1016/j.ijrobp.2007.07.2345
O’Daniel, Jennifer C., Adam S. Garden, David L. Schwartz, He Wang, Kian K. Ang, Anesa Ahamad, David I. Rosenthal, et al. “Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get?Int J Radiat Oncol Biol Phys 69, no. 4 (November 15, 2007): 1290–96. https://doi.org/10.1016/j.ijrobp.2007.07.2345.
O’Daniel JC, Garden AS, Schwartz DL, Wang H, Ang KK, Ahamad A, et al. Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get? Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1290–6.
O’Daniel, Jennifer C., et al. “Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get?Int J Radiat Oncol Biol Phys, vol. 69, no. 4, Nov. 2007, pp. 1290–96. Pubmed, doi:10.1016/j.ijrobp.2007.07.2345.
O’Daniel JC, Garden AS, Schwartz DL, Wang H, Ang KK, Ahamad A, Rosenthal DI, Morrison WH, Asper JA, Zhang L, Tung S-M, Mohan R, Dong L. Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get? Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1290–1296.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

November 15, 2007

Volume

69

Issue

4

Start / End Page

1290 / 1296

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Spinal Cord
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Prostheses and Implants
  • Parotid Gland
  • Oncology & Carcinogenesis
  • Movement
  • Humans