Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer Journal Article


Authors: Hunt, M. A.; Zelefsky, M. J.; Wolden, S.; Chui, C. S.; LoSasso, T.; Rosenzweig, K.; Chong, L.; Spirou, S. V.; Fromme, L.; Lumley, M.; Amols, H.; Ling, C. C.; Leibel, S. A.
Article Title: Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer
Abstract: Purpose: To implement intensity-modulated radiation therapy (IMRT) for primary nasopharynx cancer and to compare this technique with conventional treatment methods. Methods and Materials: Between May 1998 and June 2000, 23 patients with primary nasopharynx cancer were treated with IMRT delivered with dynamic multileaf collimation. Treatments were designed using an inverse planning algorithm, which accepts dose and dose-volume constraints for targets and normal structures. The IMRT plan was compared with a traditional plan consisting of phased lateral fields and a three-dimensional (3D) plan consisting of a combination of lateral fields and a 3D conformal plan. Results: Mean planning target volume (PTV) dose increased from 67.9 Gy with the traditional plan, to 74.6 Gy and 77.3 Gy with the 3D and IMRT plans, respectively. PTV coverage improved in the parapharyngeal region, the skull base, and the medial aspects of the nodal volumes using IMRT and doses to all normal structures decreased compared to the other treatment approaches. Average maximum cord dose decreased from 49 Gy with the traditional plan, to 44 Gy with the 3D plan and 34.5 Gy with IMRT. With the IMRT plan, the volume of mandible and temporal lobes receiving more than 60 Gy decreased by 10-15% compared to the traditional and 3D plans. The mean parotid gland dose decreased with IMRT, although it was not low enough to preserve salivary function. Conclusion: Lower normal tissue doses and improved target coverage, primarily in the retropharynx, skull base, and nodal regions, were achieved using IMRT. IMRT could potentially improve locoregional control and toxicity at current dose levels or facilitate dose escalation to further enhance locoregional control. Copyright © 2001 Elsevier Science Inc.
Keywords: clinical article; treatment planning; quality control; radiotherapy dosage; tomography, x-ray computed; algorithms; time factors; algorithm; dosimetry; three dimensional imaging; intensity modulation; radiotherapy planning, computer-assisted; radiotherapy, conformal; nasopharynx cancer; nasopharyngeal neoplasms; radiation dose distribution; parotid gland; calculation; humans; human; priority journal; article
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 49
Issue: 3
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2001-03-01
Start Page: 623
End Page: 632
Language: English
DOI: 10.1016/s0360-3016(00)01389-4
PUBMED: 11172942
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. Michael J Zelefsky
    658 Zelefsky
  2. Suzanne L Wolden
    448 Wolden
  3. Moira Lumley
    2 Lumley
  4. Lisa A Fromme
    1 Fromme
  5. Lanceford Chong
    12 Chong
  6. Steven A Leibel
    241 Leibel
  7. Howard I Amols
    157 Amols
  8. Margie A Hunt
    253 Hunt
  9. C Clifton Ling
    324 Ling
  10. Thomas J LoSasso
    89 LoSasso
  11. Chen Chui
    118 Chui
  12. Spiridon Spirou
    34 Spirou
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