A simple optimization approach for improving target dose homogeneity in intensity-modulated radiotherapy for sinonasal cancer.
Homogeneous target dose distribution in intensity-modulated radiotherapy (IMRT) for sinonasal cancer (SNC) is challenging to achieve. To solve this problem, we established and evaluated a basal-dose-compensation (BDC) optimization approach, in which the treatment plan is further optimized based on the initial plans. Generally acceptable initial IMRT plans for thirteen patients were created and further optimized individually by (1) the BDC approach and (2) a local-dose-control (LDC) approach, in which the initial plan is further optimized by addressing hot and cold spots. We compared the plan qualities, total planning time and monitor units (MUs) among the initial, BDC, LDC IMRT plans and volumetric modulated arc therapy (VMAT) plans. The BDC approach provided significantly superior dose homogeneity/conformity by 23%-48%/6%-9% compared with both the initial and LDC IMRT plans, as well as reduced doses to the organs at risk (OARs) by up to 18%, with acceptable MU numbers. Compared with VMAT, BDC IMRT yielded superior homogeneity, inferior conformity and comparable overall OAR sparing. The planning of BDC, LDC IMRT and VMAT required 30, 59 and 58 minutes on average, respectively. Our results indicated that the BDC optimization approach can achieve significantly better dose distributions with shorter planning time in the IMRT for SNC.
Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China.
Jia-Yang
JY
Lu
Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China.
Ji-Yong
JY
Zhang
Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China.
Mei
M
Li
Department of Clinical Oncology, Prince of Wales Hospital, Shatin, Hong Kong 999077, China.
Michael Lok-Man
ML
Cheung
Department of Radiology, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China.
Yang-Kang
YK
Li
Department of Laboratory, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-sen University, Shantou 515000, Guangdong, China.
Jing
J
Zheng
Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China.
Bao-Tian
BT
Huang
Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong, China.
Wu-Zhe
WZ
Zhang
D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000473:pathology*; D011879:Radiotherapy Dosage