Radiotherapy for unresectable sinonasal cancers: Dosimetric comparison of intensity modulated radiation therapy with coplanar and non-coplanar volumetric modulated arc therapy

Ester Orlandi, Tommaso Giandini, Eva Iannacone, Elena De Ponti, Mauro Carrara, Valeria Mongioj, Claudio Stucchi, Silvia Tana, Paolo Bossi, Lisa Licitra, Carlo Fallai, Emanuele Pignoli

Research output: Contribution to journalArticle

Abstract

Background and purpose To compare volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) plans for treatment of unresectable paranasal sinuses cancers (PNSCs) with different clinical presentations. Material and methods Four patients treated for primary target volume only (group 1), four requiring elective nodal irradiation (group 2) and four with positive nodes in macroscopic disease (group 3) were selected. For each patient were generated 7 fields IMRT, coplanar VMAT (c-VMAT) and non-coplanar VMAT (nc-VMAT) treatment plans. Total doses were 70 Gy and 54 Gy to high dose planning target volume (HD-PTV) and low-dose-PTV, respectively. Dose-volume histogram, conformity and homogeneity index (CI and HI), and monitor units (MUs) per Gy were evaluated. Results VMAT provided significantly better target coverage, in terms of V100% (Volume encompassed by the isodose 100%), than IMRT, in particular when nc-VMAT was used. In general, organ at risk sparing is similar with the three approaches, although nc-VMAT can allow a statistically significant reduction of dose to contralateral parotid gland and cochlea for all three groups. Conclusions VMAT can offer significant improvement of treatment for all unresectable PNSCs over existing IMRT techniques. In particular, nc-VMAT may be a further advantage for those patients with sinonasal cancers and involvement of the nodes in whom large volumes and complex/irregular shape have to be irradiated, even if clinical benefits should be established in the future.

Original languageEnglish
Pages (from-to)260-266
Number of pages7
JournalRadiotherapy and Oncology
Volume113
Issue number2
DOIs
Publication statusPublished - Nov 1 2014

Keywords

  • Dosimetric comparison
  • Intensity modulated radiation therapy
  • Normal tissue sparing
  • Target coverage
  • Unresectable paranasal sinus cancer
  • Volumetric modulated arc therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology
  • Medicine(all)

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