title: Evaluation of the dosimetric feasibility of hippocampal sparing intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma.
abstract: OBJECTIVE
  The objective of this study was to evaluate the dosimetric feasibility of using hippocampus (HPC) sparing intensity-modulated radiotherapy (IMRT) in patients with locally advanced nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  Eight cases of either T3 or T4 NPC were selected for this study. Standard IMRT treatment plans were constructed using the volume and dose constraints for the targets and organs at risk (OAR) per Radiation Therapy Oncology Group (RTOG) 0615 protocol. Experimental plans were constructed using the same criteria, with the addition of the HPC as an OAR. The two dose-volume histograms for each case were compared for the targets and OARs.
  
  
  RESULTS
  All plans achieved the protocol dose criteria. The homogeneity index, conformity index, and coverage index for the planning target volumes (PTVs) were not significantly compromised by the avoidance of the HPC. The doses to all OARs, excluding the HPC, were similar. Both the dose (Dmax, D2%, D40%, D mean, D median, D98% and D min) and volume (V5, V10, V15, V20, V30, V40 and V50) parameters for the HPC were significantly lower in the HPC sparing plans (p<0.05), except for D min (P = 0.06) and V5 (P = 0.12).
  
  
  CONCLUSIONS
  IMRT for patients with locally advanced NPC exposes the HPC to a significant radiation dose. HPC sparing IMRT planning significantly decreases this dose, with minimal impact on the therapeutic targets and other OARs.
authors.affiliation: Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, PR China.
authors.forename: Guang
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, PR China.
authors.forename: Dong
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
authors.forename: Hua
authors.initials: H
authors.lastname: Gan
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Denniston
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
authors.forename: Sicong
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, PR China.
authors.forename: Wenyong
authors.initials: W
authors.lastname: Tan
authors.affiliation: Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, PR China.
authors.forename: Desheng
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
authors.forename: Weining
authors.initials: W
authors.lastname: Zhen
authors.affiliation: Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, PR China.
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Wang
mesh_terms: D002277:Carcinoma; D006624:Hippocampus; D006801:Humans; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D058958:Organs at Risk; D011874:Radiometry; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*