Author/Editor     Smilović Radojčić, Ðeni; Švabić Kolacio, Manda; Radojčić, Milan; Rajlić, David; Casar, Božidar; Faj, Dario; Jurković, Slaven
Title     Comparison of calculated dose distributions reported as dose-to-water and dose-to-medium for intensity-modulated radiotherapy of nasopharyngeal cancer patients
Type     članek
Vol. and No.     Letnik 43, št. 4
Publication year     2018
Volume     str. 363-369
ISSN     0958-3947 - Medical dosimetry : official journal of the American Association of Medical Dosimetrists
Language     eng
Abstract     Advanced dose calculation algorithms for radiation therapy treatment planning can report external beam photon dose 2-sided, in terms of dose-to-medium (Dm) and dose-to-water (Dw). The purpose of our study was to determinate the effect of Dw and Dm reporting modes built in Elekta Monaco treatment planning system on intensity-modulated radiotherapy dose distributions for patients with nasopharyngeal cancer. For 13 patients involved in this retrospective study, 2 plans were created: 1 using Dw and another according to Dm reporting mode. Treatment plans were normalized such that 100% planning target volume should be covered by 95% of prescribed dose. Dose-volume constraints were assigned according to international standards. The comparison between dose distributions was performed evaluating quantities important for respective volumes of interest. For target volumes, heterogeneity index and conformity index methodology were used along with the maximum dose concept. Also, for the comparisons over particular organ at risk, maximum dose or mean dose as well as dose-volume concepts were used. For all target volumes and majority of organs at risk, the differences between 2 reporting modes are statistically insignificant, but this is not the case for bony structured organs at risks: mandible and cochlea. It was observed that Dw is higher than Dm with mean difference of 9.91% (p=0.000009) of the mandible volume covered with 70 Gy. The same trend was observed for left and right cochlea with difference in mean dose of 8.74% (p=0.037) and 6.87% (p=0.029), respectively. The comparative analysis of dosimetric parameters in this study shows that the selection of reporting modes in Monaco treatment planning system can produce dose differences up to 15% in high-density volumes such as mandible and cochlea, which might have clinical consequences.
Keywords     načrtovanje zdravljenja
nazofaringealni rak
obsevanje
intenzitetno modulirana radioterapija
dozimetrija
treatment planning
nasopharyngeal cancer patients
IMRT
dose reporting models