Dosimetric comparison of radiotherapy treatment plans done by IMRT and VMAT technique in head and neck cancer patients

Background: The increasing patient load in radiotherapy centres demands selection of the technique that provides plans with optimal dosimetry in terms of target volume coverage, organs at risk (OAR) sparing and a lesser treatment time. This study was designed to compare the two widely practised conformal techniques, IMRT and VMAT in head and neck cancer patients in terms of planning target volume (PTV) coverage, OAR sparing and treatment delivery parameters. Materials and methods: For ten postoperative head and neck cancer patients who had been treated by IMRT technique virtual VMAT plans were generated for study purposes. The dose prescribed to PTV was 60 Gy in 30 fractions. The dose-volume parameters of PTV and OARs and the treatment delivery parameters were compared amongst both the techniques. Statistical significance was calculated using paired ‘t’ test. Results: Both the plans were comparable in terms of dosimetry. The only significant difference being better conformity in the IMRT plans. The dose to OARs was also comparable in both the techniques except for a significant reduction in the point dose to brainstem with the IMRT technique. Given the treatment delivery parameters, there was a significant reduction in the treatment delivery time and monitor units with the VMAT technique compared to the IMRT technique. Conclusion: VMAT technique gave comparable plans to that of the IMRT technique in terms of dosimetry but reduced the treatment time. It seems feasible in radiotherapy centres with increased patient load

Prosthetic Rehabilitation of a Patient with Xerostomia Following Radiotherapy: A Case Report

Xerostomia, characterized by a subjective feeling of dryness in the mouth has profound consequences on oral health including dental caries, oral discomfort, and a diminished overall quality of life. The absence or alteration of saliva can have profound consequences, manifesting as dental caries, oral discomfort, and a diminished overall quality of life. The present case report details a case of a reservoir denture, showcasing successful outcomes in the innovative management of xerostomia. By describing an alternative technique for denture fabrication, the present case report focuses on the construction of a mandibular reservoir dentur

Conformal radiotherapy plans for palliative bone metastasis - comparison of dosimetric parameters

Background:Palliative radiotherapy offers significant relief in the huge physical distress of patients with bony metastasis. The enormous potential of conformal techniques has not been tested in palliative settings. However,the increasing life span of patients with metastatic disease demands to optimize the radiotherapy techniques to provide maximal durable symptomatic relief. Despitean increase in the utilization of the 3DCRT technique for palliative bony metastasis, the optimal beam arrangement remains unknown. Materials and Methods:Ten patients of vertebral bony metastasis were retrospectively selected and four virtual 3DCRT plans were generated for each patient. The field approaches were a single field, two fields, three fields and five field approaches. For PTV, D90, D50, Dmean, Conformity index (CI) were evaluated.Dmean was evaluated for the esophagus, bowel, kidneys, and combined lungs. Dose-volume histograms were computed for the various treatment plans and compared. Statistical analysis was done by ANOVA test. Results:A total of forty radiotherapy plans were generated. PTV parameters were significantly better with two field plans over one field plans in terms of D90 (p= 0.002), D50 (p= 0.02), Dmean(p=0.0009). Dmeanwassignificantly better with three field approach compared to two field approach (p=0.0006). The Dmeanwas significantly increased for organs at risk in two fields and three field plans.Five field approach did not showan advantage in terms of dosimetry of PTV but there was a significant rise in the dose to Organs at risk (OAR’s). Conclusion:The three field plans showed better dose distribution to the PTV with an acceptable increase in the dose to OAR’s