Evidence map›Paper›PMID 26701749›Full record

ArticleRadiation oncology (London, England)2015

Fast Helical Tomotherapy in a head and neck cancer planning study: is time priceless?

Dirk Van Gestel, Geert De Kerf, Kristien Wouters, Wouter Crijns, Jan B Vermorken, Vincent Gregoire, Dirk Verellen

Abstract read
In one paragraph

Article in Radiation oncology (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dirk Van GestelUniversity Radiotherapy department Antwerp (URA), Antwerp, Belgium. dirk.vangestel@bordet.be.
Geert De KerfUniversity Radiotherapy department Antwerp (URA), Antwerp, Belgium. dekerfgeert@gmail.com.
Kristien WoutersScientific Coordination and Biostatistics, Antwerp University Hospital, Edegem, Belgium. kristien.wouters@uza.be.
Wouter CrijnsDepartment of Radiation Oncology, Leuvens Kankerinstituut, Leuven, Belgium. wouter.crijns@uz.kuleuven.be.
Jan B VermorkenFaculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. jan.b.vermorken@uza.be.
Vincent GregoireRadiation Oncology Department & Centre for Molecular Imaging and Experimental Radiotherapy, St-Luc University Hospital, Brussels, Belgium. vincent.gregoire@uclouvain.be.
Dirk VerellenRadiotherapy UZ Brussel, Faculty of Medicine and Pharmacy Vrije Universiteit Brussel, Brussels, Belgium. dirk.verellen@uzbrussel.be.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe last few years, in radiotherapy there has been a growing focus on speed of treatment delivery (largely driven by economical and commercial interests). This study investigates the influence of treatment time on plan quality for helical tomotherapy (HT), using delivery times with Volumetric Modulated Arc Therapy (VMAT; Rapid Arc [RA]) as reference.

methodsIn a previous study, double arc RA (Eclipse) and standard HT plans (TomoHD™) were created for five oropharyngeal cancer patients and reported according to ICRU 83 guidelines. By modifying the beam width from 2.5 to 5.0 cm, elevating the pitch and lowering the modulation factor, "TomoFast" (TF) plans were generated with treatment times equal to RA plans. To quantify the impact of TF's craniocaudal gradient, similar plans were generated on TomoEdge(TM) (TomoEdgeFast;TEF). The homogeneity index (HI), conformity index (CI), mean dose, Dnear-max (D2) and Dnear-min (D98) of the PTVs were analyzed as well as the mean dose, specific critical doses and volumes of 26 organs at risk (OARs). Data were analyzed using repeated measures ANOVA.

resultsWith a mean treatment time of 3.05 min (RA), 2.89 min (TF) and 2.95 min (TEF), PTVtherapeutic coverage was more homogeneous with TF (HI.07;SE.01) and TEF (HI.08;SE.01) compared to RA (HI.10;SE.01), while PTVprophylactic was most homogeneous with RA. Mean doses to parotid glands were comparable for RA, TF, TEF: 25.62, 25.34, 23.09 Gy for contralateral and 32.02, 31.96, 30.01 Gy for ipsilateral glands, respectively. OARs' mean doses varied between different approaches not favoring a particular technique. TF's higher dose to OARs at the cranial-caudal edges of the PTVs and its higher integral dose, both due to the extended cranial-caudal gradient, seems to be solved by the new TomoEdge™ software. However, all these faster techniques lose part of standard TomoHD's OAR sparing capacity

conclusionIt is possible to treat oropharyngeal cancer patients using HT (TF/TEF) within time-frames observed for RA maintaining comparable target coverage and sparing of OARs. This study indicates that treatment time is not technology specific, rather an operator's decision on balancing efficiency and quality.

Indexed as

Time-to-TreatmentHead and Neck NeoplasmsHumansRadiotherapy DosageRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-Assisted

Identifiers

PMID26701749
PMCPMC4690403

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