Akademik Veri Yönetim Sistemi
Integrative Cancer Science and Therapeutics, cilt.3, sa.1, ss.354-357, 2016 (Hakemli Dergi)
Abstract: Limiting the unwanted exposure level of neighboring healthy tissues including carotid artery is important with respect to carotid artery atherosclerosis risk, which could lead to cerebrovascular events, in patients undergoing radiotherapy for neck and head malignancies. The aim of this study was to compare carotid artery irradiation exposure levels in T1-2 glottic cancer patients undergoing radiotherapy with different modalities namely three dimensional conformal radiotherapy (3DCRT-opposed laterals field (OLF), three field (3F), intensity-modulated radiotherapy (IMRT) and intensity-modulated arc therapy (IMAT). The radiation exposure level of carotid artery was determined by use of InDigital Imaging and Communications in Medicine radiotherapy (DICOM-RT) datasets. This simulation-based dosimetric analysis was performed by use of DICOM-RT data for seven T1-2 glottic squamous cell carcinoma patients who received conventional 66Gy dose in 33 fractions, and levels of carotid exposure for 3DCRT, IMRT and IMAT techniques was calculated for each patient. The calculations involved PTV D95, PTV Dmax, left and right carotid artery doses V35,V50 and V63Gy, conformity index (CI), homogeneity index (HI) and monitor unit (MU) for each plan. Effective target volume was ensured with all the techniques tested. IMAT plan yielded the lowest carotid artery exposure as values of V35, V50 and V63 for carotid artery were lowest in IMAT plans. PTV V95, HI values of IMRT plans were significantly better. CI values for 3DCRT-3F, IMRT and IMAT plans were not significantly different, all being significantly lower than 3DCRT-OFL. The results of this pilot study indicates that IMAT plan provides the lowest risk of carotid artery exposure and thereby related complications in treatment of T1-2 glottic cancers with radiotherapy.