Helical tomotherapy as a new treatment technique for whole abdominal irradiation.

Abstract

PURPOSE:

To describe a new intensity-modulated radiotherapy (IMRT) technique using helical tomotherapy for whole abdominal irradiation (WAI) in patients with advanced ovarian cancer.

MATERIAL AND METHODS:

A patient with radically operated ovarian cancer FIGO stage IIIc was treated in a prospective clinical trial with WAI to a total dose of 30 Gy in 1.5-Gy fractions as an additional therapy after adjuvant platinum-based chemotherapy. The planning target volume (PTV) included the entire peritoneal cavity. PTV was adapted according to breathing motion as detected in a four-dimensional respiratory-triggered computed tomography (4D-CT). Inverse treatment planning was done with the Hi-Art tomotherapy planning station. Organs at risk (OARs) were kidneys, liver, bone marrow, spinal cord, thoracic and lumbosacral vertebral bodies, and pelvic bones. Daily control of positioning accuracy was performed with megavoltage computed tomography (MV-CT).

RESULTS:

Helical tomotherapy enabled a very homogeneous dose distribution with excellent sparing of OARs and coverage of the PTV (V90 of 93.1%, V95 of 86.9%, V105 of 1.9%, and V110 of 0.01%). Mean liver dose was 21.57 Gy and mean kidney doses were 9.75 Gy and 9.14 Gy, respectively. Treatment could be performed in 18.1 min daily and no severe side effects occurred.

CONCLUSION:

Helical tomotherapy is feasible and fast for WAI. Tomotherapy enabled excellent coverage of the PTV and effective sparing of liver, kidneys and bone marrow.

• Authors: Nathalie Rochet, Florian Sterzing, Alexandra Jensen, Julien Dinkel, Klaus Herfarth, Kai Schubert, Michael Eichbaum, Andreas Schneeweiss, Christof Sohn, Juergen Debus, Wolfgang Harms
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 184 Issue 3 Pg. 145-9 (Mar 2008) ISSN: 0179-7158 [Print] Germany
• PMID: 18330510 (Publication Type: Case Reports, Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Antineoplastic Agents, Phytogenic
• Carboplatin
• Paclitaxel

Topics

• Abdomen (radiation effects)
• Algorithms
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Antineoplastic Agents, Phytogenic (administration & dosage, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols
• Bone Marrow (radiation effects)
• Carboplatin (administration & dosage, therapeutic use)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Image Processing, Computer-Assisted
• Kidney (radiation effects)
• Liver (radiation effects)
• Middle Aged
• Neoplasm Staging
• Ovarian Neoplasms (drug therapy, pathology, radiotherapy, surgery)
• Ovary (pathology)
• Paclitaxel (administration & dosage, therapeutic use)
• Prospective Studies
• Radiotherapy Dosage
• Radiotherapy Planning, Computer-Assisted
• Radiotherapy, Adjuvant
• Radiotherapy, Intensity-Modulated (methods)
• Time Factors
• Tomography, Spiral Computed (methods)
• Treatment Outcome