Quality assurance of dysphagia-optimised intensity modulated radiotherapy treatment planning for head and neck cancer. (October 2021)

• Record Type: Journal Article
• Authors: Tyler, Justine; Bernstein, David; Seithel, Matthew; Rooney, Keith; Petkar, Imran; Miles, Elizabeth; Clark, Catharine H; Hall, Emma; Nutting, Chris
• Is Part Of: Physics and imaging in radiation oncology. Volume 20(2021)
• Page Start: 46
• Page End: 50
• Publication Date: 2021-10
• Subjects: CERR Computational Environment for Radiotherapy Research -- DARS dysphagia/aspiration related structures -- DICOM Digital Imaging and Communications in Medicine -- DO-IMRT dysphagia optimised intensity modulated radiotherapy -- ICR-CTSU Clinical Trials and Statistics Unit and the Institute of Cancer Research -- IPCM inferior pharyngeal constrictor muscle -- NIHR National Institute for Health Research -- PAF plan assessment form -- RTQA radiotherapy quality assurance -- RTTQA UK's National Radiotherapy Trials Quality Assurance Group -- S-IMRT standard intensity modulated radiotherapy -- SMPCM superior and middle pharyngeal constrictor muscles -- TMG Trial Management Group; Intensity modulated radiotherapy (IMRT) -- Volumetric arc therapy (VMAT) -- Head and neck cancer -- Dysphagia -- Randomised controlled trial -- Quality assurance; Radiotherapy -- Periodicals; Radiation dosimetry -- Periodicals; Cancer -- Imaging -- Periodicals; Oncology -- Periodicals; 615.842
• DOI: 10.1016/j.phro.2021.10.003
• Languages: English
• ISSNs: 2405-6316

Abstract

Highlights: A novel dysphagia-optimised technique was developed within a clinical trial. All participating centres achieved protocol compliant final plans. Larger CTV-PTV margins were associated with higher doses to adjacent OAR. A 3 mm margin is recommended for dysphagia-optimisation if local practices allow. Abstract: This study aimed to assess the impact of the margin applied to the clinical target volume, to create the planning target volume, on plan quality of a novel dysphagia-optimised intensity modulated radiotherapy technique developed within a head and neck cancer multicentre randomised controlled trial. Protocol compliant plans were used for a single benchmark planning case. Larger margins were associated with higher doses to adjacent organs at risk, particularly the inferior pharyngeal constrictor muscle, but coincided with some improved low dose target coverage. A 3 mm margin is recommended for this technique if local practices allow.