Comparison of treatment plans using intensity-modulated radiotherapy and three-dimensional conformal radiotherapy for paranasal sinus carcinoma.
OBJECTIVE
To compare intensity-modulated radiotherapy (IMRT) treatment planning with three-dimensional conformal radiotherapy (3D-CRT) planning for paranasal sinus carcinoma.


METHODS
Treatment plans using traditional 3-field technique, 3D-CRT planning, and inverse planning IMRT were developed for a case of paranasal sinus cancer requiring adjuvant radiotherapy. Plans were compared with respect to dose conformality, dose-volume histograms, doses to critical normal tissues, and ease of treatment delivery.


RESULTS
The inverse-planned IMRT technique was more conformal around the tumor target volume than conventional techniques. The dose-volume histograms demonstrated significantly better critical normal-tissue sparing with the IMRT plans, while able to deliver a minimum dose of 60 Gy to the clinical tumor volume and 70 Gy to the gross tumor volume. Acute toxicities in our analysis were minimal.


CONCLUSIONS
IMRT planning provided improved tumor target coverage when compared to 3D-CRT treatment planning. There was significant sparing of optic structures and other normal tissues, including the brainstem. Inverse planning IMRT provided the best treatment for all paranasal sinus carcinomas, but required stringent immobilization criteria. Further studies are needed to establish the true clinical advantage of this modality.
Huang
David
D
Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA.
Xia
Ping
P
Akazawa
Pam
P
Akazawa
Clayton
C
Quivey
Jeanne M
JM
Verhey
Lynn J
LJ
Kaplan
Michael
M
Lee
Nancy
N
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001933:Brain Stem / Q000293:injuries / Q000528:radiation effects; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005131:Eye Injuries / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007103:Immobilization; D008397:Masks; D008444:Maxillary Sinus Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D009897:Optic Chiasm / Q000528:radiation effects; D020221:Optic Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*
D000970:Antineoplastic Agents