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Strahlentherapie und Onkologie

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01-08-2012 | Original article

Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin’s disease

Authors: J. Koeck, Y. Abo-Madyan, H.T. Eich, F. Stieler, J. Fleckenstein, J. Kriz, R.-P. Mueller, F. Wenz, F. Lohr

Published in: Strahlentherapie und Onkologie | Issue 8/2012

Abstract

Background and purpose

Conventional algorithms show uncertainties in dose calculation already for three-dimensional conformal radiotherapy (3D-CRT). Intensity-modulated radiotherapy (IMRT) might even increase these. We wanted to assess differences in dose distribution for pencil beam (PB), collapsed cone (CC), and Monte Carlo (MC) algorithm for both 3D-CRT and IMRT in patients with mediastinal Hodgkin lymphoma.

Patients and methods

Based on 20 computed tomograph (CT) datasets of patients with mediastinal Hodgkin lymphoma, we created treatment plans according to the guidelines of the German Hodgkin Study Group (GHSG) with PB and CC algorithm for 3D-CRT and with PB and MC algorithm for IMRT. Doses were compared for planning target volume (PTV) and organs at risk.

Results

For 3D-CRT, PB overestimated PTV₉₅ and V₂₀ of the lung by 6.9% and 3.3% and underestimated V₁₀ of the lung by 5.8%, compared to the CC algorithm. For IMRT, PB overestimated PTV₉₅, V₂₀ of the lung, V₂₅ of the heart and V₁₀ of the female left/right breast by 8.1%, 25.8%, 14.0% and 43.6%/189.1%, and underestimated V₁₀ of the lung, V₄ of the heart and V₄ of the female left/right breast by 6.3%, 6.8% and 23.2%/15.6%, compared to MC.

Conclusion

The PB algorithm underestimates low doses to the organs at risk and overestimates dose to PTV and high doses to the organs at risk. For 3D-CRT, a well-modeled PB algorithm is clinically acceptable; for IMRT planning, however, an advanced algorithm such as CC or MC should be used at least for part of the plan optimization.

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Title: Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin’s disease
Authors: J. Koeck
Y. Abo-Madyan
H.T. Eich
F. Stieler
J. Fleckenstein
J. Kriz
R.-P. Mueller
F. Wenz
F. Lohr
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: Strahlentherapie und Onkologie / Issue 8/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-012-0144-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical relevance of different dose calculation strategies for mediastinal IMRT in Hodgkin’s disease

Abstract

Background and purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Patients and methods

Results

Conclusion

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