PURPOSE: To investigate the feasibility of adaptive intensity-modulated radiation therapy (IMRT) using dose painting by numbers (DPBN) for head-and-neck cancer. METHODS AND MATERIALS: Each patient's treatment used three separate treatment plans: fractions 1-10 used a DPBN ([(18)-F]fluoro-2-deoxy-D-glucose positron emission tomography [(18)F-FDG-PET]) voxel intensity-based IMRT plan based on a pretreatment (18)F-FDG-PET/computed tomography (CT) scan; fractions 11-20 used a DPBN plan based on a (18)F-FDG-PET/CT scan acquired after the eighth fraction; and fractions 21-32 used a conventional (uniform dose) IMRT plan. In a Phase I trial, two dose prescription levels were tested: a median dose of 80.9 Gy to the high-dose clinical target volume (CTV(high_dose)) (dose level I) and a median dose of 85.9 Gy to the gross tumor volume (GTV) (dose level II). Between February 2007 and August 2009, 7 patients at dose level I and 14 patients at dose level II were enrolled. RESULTS: All patients finished treatment without a break, and no Grade 4 acute toxicity was observed. Treatment adaptation (i.e., plans based on the second (18)F-FDG-PET/CT scan) reduced the volumes for the GTV (41%, p = 0.01), CTV(high_dose) (18%, p = 0.01), high-dose planning target volume (14%, p = 0.02), and parotids (9-12%, p < 0.05). Because the GTV was much smaller than the CTV(high_dose) and target adaptation, further dose escalation at dose level II resulted in less severe toxicity than that observed at dose level I. CONCLUSION: To our knowledge, this represents the first clinical study that combines adaptive treatments with dose painting by numbers. Treatment as described above is feasible.
PURPOSE: To investigate the feasibility of adaptive intensity-modulated radiation therapy (IMRT) using dose painting by numbers (DPBN) for head-and-neck cancer. METHODS AND MATERIALS: Each patient's treatment used three separate treatment plans: fractions 1-10 used a DPBN ([(18)-F]fluoro-2-deoxy-D-glucose positron emission tomography [(18)F-FDG-PET]) voxel intensity-based IMRT plan based on a pretreatment (18)F-FDG-PET/computed tomography (CT) scan; fractions 11-20 used a DPBN plan based on a (18)F-FDG-PET/CT scan acquired after the eighth fraction; and fractions 21-32 used a conventional (uniform dose) IMRT plan. In a Phase I trial, two dose prescription levels were tested: a median dose of 80.9 Gy to the high-dose clinical target volume (CTV(high_dose)) (dose level I) and a median dose of 85.9 Gy to the gross tumor volume (GTV) (dose level II). Between February 2007 and August 2009, 7 patients at dose level I and 14 patients at dose level II were enrolled. RESULTS: All patients finished treatment without a break, and no Grade 4 acute toxicity was observed. Treatment adaptation (i.e., plans based on the second (18)F-FDG-PET/CT scan) reduced the volumes for the GTV (41%, p = 0.01), CTV(high_dose) (18%, p = 0.01), high-dose planning target volume (14%, p = 0.02), and parotids (9-12%, p < 0.05). Because the GTV was much smaller than the CTV(high_dose) and target adaptation, further dose escalation at dose level II resulted in less severe toxicity than that observed at dose level I. CONCLUSION: To our knowledge, this represents the first clinical study that combines adaptive treatments with dose painting by numbers. Treatment as described above is feasible.
Authors: Abdallah S R Mohamed; Carlos E Cardenas; Adam S Garden; Musaddiq J Awan; Crosby D Rock; Sarah A Westergaard; G Brandon Gunn; Abdelaziz M Belal; Ahmed G El-Gowily; Stephen Y Lai; David I Rosenthal; Clifton D Fuller; Michalis Aristophanous Journal: Radiother Oncol Date: 2017-07-31 Impact factor: 6.280
Authors: Uulke A van der Heide; Antonetta C Houweling; Greetje Groenendaal; Regina G H Beets-Tan; Philippe Lambin Journal: Magn Reson Imaging Date: 2012-07-06 Impact factor: 2.546
Authors: Stephen R Bowen; Jatinder Saini; Tobias R Chapman; Robert S Miyaoka; Paul E Kinahan; George A Sandison; Tony Wong; Hubert J Vesselle; Matthew J Nyflot; Smith Apisarnthanarax Journal: Radiother Oncol Date: 2015-04-28 Impact factor: 6.280
Authors: Julie Schatteman; Dirk Van Gestel; Dieter Berwouts; Werner De Gersem; Geert De Kerf; Wilfried De Neve; Bie De Ost; Ana Maria Luiza Olteanu; Sylvie Rottey; Tom Vercauteren; Ingeborg Goethals; Fréderic Duprez Journal: Strahlenther Onkol Date: 2018-03-19 Impact factor: 3.621
Authors: Stéphanie Servagi-Vernat; Sarah Differding; Francois-Xavier Hanin; Daniel Labar; Anne Bol; John A Lee; Vincent Grégoire Journal: Eur J Nucl Med Mol Imaging Date: 2014-02-26 Impact factor: 9.236