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Quantifying the dosimetric trade-offs when using intensity-modulated radiotherapy to treat concave targets containing normal tissues.

Publication ,  Journal Article
Reese, AS; Das, SK; Kirkpatrick, JP; Marks, LB
Published in: Int J Radiat Oncol Biol Phys
February 1, 2009

PURPOSE: To quantitatively assess the relationship between intensity-modulated radiotherapy (IMRT)-driven sparing of dose to normal tissues located "within" concave targets with heterogeneity in dose delivered to the target and redistribution of dose to normal tissue beyond the concavity. METHODS AND MATERIALS: A combination of idealized and real-patient volumes was considered. Multiple IMRT plans were generated with progressive dose restriction to the normal tissue within the concavity. We quantified the impact of such sparing on the heterogeneity of dose within the target tissue itself, and the dose received by normal tissues beyond the concavity. RESULTS: As the dose to the normal tissue concavity region is reduced, the heterogeneity in dose delivered to the target increases in an exponential fashion. Furthermore, there is a rapid increase in redistributed dose to other normal tissue regions, particularly to the other normal tissues immediately adjacent to the outside edges of the concavity. Increasingly restricting dose to these adjacent normal tissue regions resulted in increasing dose to the normal tissue in the concavity and increasing dose heterogeneity in the target volume. CONCLUSIONS: For targets with concavities, there are dosimetric consequences associated with reducing dose to normal tissue located within these concavities. There appears to be a trade-off between the heterogeneity in dose delivered to the target, the mean dose to the concavity, and the redistributed dose to other normal tissues. Understanding the interaction between these dosimetric factors can aid the planner in assessing the feasibility of a desired dose distribution.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

February 1, 2009

Volume

73

Issue

2

Start / End Page

585 / 593

Location

United States

Related Subject Headings

  • Rectum
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiography
  • Radiation Injuries
  • Prostatic Neoplasms
  • Oncology & Carcinogenesis
  • Mesothelioma
  • Male
 

Citation

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MLA
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Reese, A. S., Das, S. K., Kirkpatrick, J. P., & Marks, L. B. (2009). Quantifying the dosimetric trade-offs when using intensity-modulated radiotherapy to treat concave targets containing normal tissues. Int J Radiat Oncol Biol Phys, 73(2), 585–593. https://doi.org/10.1016/j.ijrobp.2008.09.044
Reese, Adam S., Shiva K. Das, John P. Kirkpatrick, and Lawrence B. Marks. “Quantifying the dosimetric trade-offs when using intensity-modulated radiotherapy to treat concave targets containing normal tissues.Int J Radiat Oncol Biol Phys 73, no. 2 (February 1, 2009): 585–93. https://doi.org/10.1016/j.ijrobp.2008.09.044.
Reese AS, Das SK, Kirkpatrick JP, Marks LB. Quantifying the dosimetric trade-offs when using intensity-modulated radiotherapy to treat concave targets containing normal tissues. Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):585–93.
Reese, Adam S., et al. “Quantifying the dosimetric trade-offs when using intensity-modulated radiotherapy to treat concave targets containing normal tissues.Int J Radiat Oncol Biol Phys, vol. 73, no. 2, Feb. 2009, pp. 585–93. Pubmed, doi:10.1016/j.ijrobp.2008.09.044.
Reese AS, Das SK, Kirkpatrick JP, Marks LB. Quantifying the dosimetric trade-offs when using intensity-modulated radiotherapy to treat concave targets containing normal tissues. Int J Radiat Oncol Biol Phys. 2009 Feb 1;73(2):585–593.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

February 1, 2009

Volume

73

Issue

2

Start / End Page

585 / 593

Location

United States

Related Subject Headings

  • Rectum
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • Radiography
  • Radiation Injuries
  • Prostatic Neoplasms
  • Oncology & Carcinogenesis
  • Mesothelioma
  • Male