Literature DB >> 18207597

Evaluating target coverage and normal tissue sparing in the adjuvant radiotherapy of malignant pleural mesothelioma: helical tomotherapy compared with step-and-shoot IMRT.

Florian Sterzing1, Gabriele Sroka-Perez, Kai Schubert, Marc W Münter, Christian Thieke, Peter Huber, Jürgen Debus, Klaus K Herfarth.   

Abstract

PURPOSE: To evaluate the potential of helical tomotherapy in the adjuvant treatment of malignant pleural mesothelioma and compare target homogeneity, conformity and normal tissue dose with step-and-shoot intensity-modulated radiotherapy. METHODS AND MATERIALS: Ten patients with malignant pleural mesothelioma who had undergone neoadjuvant chemotherapy with cisplatin and permetrexed followed by extrapleural pneumonectomy (EPP) were treated in our department with 54 Gy to the hemithorax delivered by step-and-shoot IMRT. A planning comparison was performed by creating radiation plans for helical tomotherapy. The different plans were compared by analysing target homogeneity using the homogeneity indices HI(max) and HI(min) and target conformity by using the conformity index CI(95). To assess target coverage and normal tissue sparing TV(90), TV(95) and mean and maximum doses were compared.
RESULTS: Both modalities achieved excellent dose distributions while sparing organs at risk. Target coverage and homogeneity could be increased significantly with helical tomotherapy compared with step-and-shoot IMRT. Mean dose to the contralateral lung could be lowered beyond 5 Gy.
CONCLUSIONS: Our planning study showed that helical tomotherapy is an excellent option for the adjuvant intensity-modulated radiotherapy of MPM. It is capable of improving target coverage and homogeneity.

Entities:  

Mesh:

Year:  2008        PMID: 18207597     DOI: 10.1016/j.radonc.2007.12.010

Source DB:  PubMed          Journal:  Radiother Oncol        ISSN: 0167-8140            Impact factor:   6.280


  18 in total

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2.  Adjuvant intensity-modulated proton therapy in malignant pleural mesothelioma. A comparison with intensity-modulated radiotherapy and a spot size variation assessment.

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Review 8.  The role of radical radiotherapy in the management of malignant pleural mesothelioma: A systematic review.

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10.  Tomotherapy PET-guided dose escalation: A dosimetric feasibility study for patients with malignant pleural mesothelioma.

Authors:  Angelo Maggio; Claudia Cutaia; Amalia Di Dia; Sara Bresciani; Anna Miranti; Matteo Poli; Elena Del Mastro; Elisabetta Garibaldi; Pietro Gabriele; Michele Stasi
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