title: Dosimetric evaluation and clinical outcome in post-operative patients of carcinoma vulva treated with intensity-modulated radiotherapy.
abstract: BACKGROUND
  To compare dosimetric parameters of intensity-modulated radiation therapy (IMRT) with 3D conformal radiotherapy (3DCRT) in post-operative patients of vulvar cancer and to assess clinical outcome and toxicity with IMRT.
  
  
  METHODS
  A total of 8 post-operative patients of vulvar cancer were treated with IMRT. All patients were also planned by 3DCRT for comparison with IMRT. The two plans were compared in terms of conformity index, homogeneity index, tumor control probability (TCP) and normal tissue complication probability (NTCP) for the planning target volume and organs at risk (OAR).
  
  
  RESULTS
  IMRT resulted in significantly lesser doses to rectum, bladder, bowel and femoral head as compared with 3DCRT plans. Mean conformity and homogeneity indices were better and within range with IMRT. The TCP was comparable between the two treatment plans and NTCP for rectum, bladder, bowel and femoral head was significantly less with IMRT as compared with 3DCRT. Treatment was well-tolerated and none of the patients developed Grade 3 or higher toxicity.
  
  
  CONCLUSIONS
  IMRT yielded superior plans with respect to target coverage, homogeneity and conformality while lowering dose to adjacent OAR as compared with 3DCRT. Thus, IMRT offers a reduction in NTCP while maintaining TCP.
authors.affiliation: Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: D
authors.initials: D
authors.lastname: Khosla
authors.forename: F D
authors.initials: FD
authors.lastname: Patel
authors.forename: A K
authors.initials: AK
authors.lastname: Shukla
authors.forename: B
authors.initials: B
authors.lastname: Rai
authors.forename: A S
authors.initials: AS
authors.lastname: Oinam
authors.forename: S C
authors.initials: SC
authors.lastname: Sharma
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery