Multi-criteria optimization achieves superior normal tissue sparing in intensity-modulated radiation therapy for oropharyngeal cancer patients. (May 2018)

• Record Type: Journal Article
• Authors: Xiao, Jianghong; Li, Yan; Shi, Huashan; Chang, Tangel; Luo, Yong; Wang, Xuetao; He, Yang; Chen, Nianyong
• Is Part Of: Oral oncology. Volume 80(2018)
• Page Start: 74
• Page End: 81
• Publication Date: 2018-05
• Subjects: Head and neck cancer -- Oropharyngeal cancer -- Intensity-modulated radiation therapy -- Radiotherapy planning -- Multi-criteria optimization -- Normal tissue sparing; BS brainstem -- GL glottic larynx -- LC and RC left and right cochleae -- LM and RM left and right mandible -- LPG and RPG left and right parotid glands -- MCOp and MCOd the multi-criteria optimization plans navigated by physicians and dosimetrists -- OC oral cavity -- SC spinal cord; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2018.03.020
• Languages: English
• ISSNs: 1368-8375

Abstract

Graphical abstract: Highlights: Multi-criteria optimization significantly reduced the dose of organs at risk. Multi-criteria optimization significantly decreased the active planning time. Navigations by physicians could be beneficial to the dose sparing of organs at risk. The constraints could dominate the results of Multi-criteria optimization. Abstract: Objectives: To evaluate the benefit of intensity-modulated radiation therapy (IMRT) with multi-criteria optimization (MCO) in patients with oropharyngeal cancer (OPC) and compare the dose difference between the MCO plans navigated by physicians and dosimetrists. Materials and methods: The conventional IMRT plans (nonMCO) and MCO IMRT plans navigated by physicians and dosimetrists (MCOp and MCOd) were created for 30patients with OPC. All the plans were reviewed, and the planning time and dose-volume parameters were compared. Results: The difference of D95 among three kinds of plans was not significant ( p > 0.05). The maximum dose and D2 of spinal cord, brain stem, the mean dose of bilateral parotids, cochlea, oral cavity and glottic larynx were lower in MCO plans than those in nonMCO plans ( p < 0.017). Furthermore, MCOp showed better bilateral parotids, oral cavity and glottic larynx sparing compared to MCOd ( p < 0.017), in which the magnitude was related to the overlapping volume of the corresponding organ at risk (OAR) and targets. The active planning time was reduced by a median of 94.3 min (MCOd vs. nonMCO) or 91.6 min (MCOp vs. nonMCO). Conclusion: MCO IMRT plans significantly reduced the dose of OARs and the active planning time, without compromising the target coverage in OPC patients; navigations by physicians could be beneficial to the dose sparing of the OARs with high complication rate and those overlapping with targets; the constraints could be the predominant factor affecting the results of optimization in the MCO IMRT planning.