Feasibility of image-guided radiotherapy based on helical tomotherapy to reduce contralateral parotid dose in head and neck cancer
Menée sur 52 patients atteints d'un cancer de la tête et du cou, cette étude évalue la faisabilité d'une radiothérapie guidée par l'image et basée sur la tomothérapie hélicoïdale pour réduire la dose de rayonnements affectant la glande parotide controlatérale
BACKGROUND:To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastasesMETHODS:A retrospective review of 52 patients undergoing radiation for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed.RESULTS:Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40 Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20 Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26 Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was,respectively,14.1 Gy and 24.& Gy for the SC and CC plans (p<0.0001). The volume of contralateral parotid receiving 40 Gy or more was respectively 5.3% and 18.2% (p<0.0001)CONCLUSION:Tomotherapy for head and neck cancer minimized radiotherapy dose to the contraleral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage.