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Focal dose escalation using FDG-PET-guided intensity-modulated radiation therapy boost for postoperative local recurrent rectal cancer: a planning study with comparison of DVH and NTCP
- Source :
- BMC Cancer, BMC Cancer, Vol 10, Iss 1, p 127 (2010)
- Publisher :
- Springer Nature
-
Abstract
- Background To evaluate the safety of focal dose escalation to regions with standardized uptake value (SUV) >2.0 using intensity-modulated radiation therapy (IMRT) by comparison of radiotherapy plans using dose-volume histograms (DVHs) and normal tissue complication probability (NTCP) for postoperative local recurrent rectal cancer Methods First, we performed conventional radiotherapy with 40 Gy/20 fr. (CRT 40 Gy) for 12 patients with postoperative local recurrent rectal cancer, and then we performed FDG-PET/CT radiotherapy planning for those patients. We defined the regions with SUV > 2.0 as biological target volume (BTV) and made three boost plans for each patient: 1) CRT boost plan, 2) IMRT without dose-painting boost plan, and 3) IMRT with dose-painting boost plan. The total boost dose was 20 Gy. In IMRT with dose-painting boost plan, we increased the dose for BTV+5 mm by 30% of the prescribed dose. We added CRT boost plan to CRT 40 Gy (summed plan 1), IMRT without dose-painting boost plan to CRT 40 Gy (summed plan 2) and IMRT with dose-painting boost plan to CRT 40 Gy (summed plan 3), and we compared those plans using DVHs and NTCP. Results Dmean of PTV-PET and that of PTV-CT were 26.5 Gy and 21.3 Gy, respectively. V50 of small bowel PRV in summed plan 1 was significantly higher than those in other plans ((summed plan 1 vs. summed plan 2 vs. summed plan 3: 47.11 ± 45.33 cm3 vs. 40.63 ± 39.13 cm3 vs. 41.25 ± 39.96 cm3(p < 0.01, respectively)). There were no significant differences in V30, V40, V60, Dmean or NTCP of small bowel PRV. Conclusions FDG-PET-guided IMRT can facilitate focal dose-escalation to regions with SUV above 2.0 for postoperative local recurrent rectal cancer.
- Subjects :
- Antimetabolites, Antineoplastic
Cancer Research
Colorectal cancer
medicine.medical_treatment
Standardized uptake value
lcsh:RC254-282
Fluorodeoxyglucose F18
Surgical oncology
Dose escalation
medicine
Genetics
Humans
Tegafur
Recurrent Rectal Cancer
medicine.diagnostic_test
Rectal Neoplasms
business.industry
Radiotherapy Planning, Computer-Assisted
Dose-Response Relationship, Radiation
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Radiation therapy
Drug Combinations
Oxonic Acid
Oncology
Positron emission tomography
Positron-Emission Tomography
Radiotherapy, Intensity-Modulated
Neoplasm Recurrence, Local
Radiopharmaceuticals
Nuclear medicine
business
Complication
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Volume :
- 10
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....2ce237b6fa408aaa080f0e309256028d
- Full Text :
- https://doi.org/10.1186/1471-2407-10-127