3 research outputs found
Assessment and topographic characterization of locoregional recurrences in head and neck tumours
Purpose:
To evaluate the differences between three methods of classification of recurrences in patients with head
and neck tumours treated with Radiation Therapy (RT).
Materials and methods:
367 patients with head and neck tumours were included in the study. Tumour
recurrences were delineated in the CT images taken during patient follow-up and deformable registration was used
to transfer this volume into the planning CT. The methods used to classify recurrences were:
methodCTV
quantified
the intersection volume between the recurrence and the Clinical Target Volume (CTV);
methodTV
quantified the
intersection between the Treated Volume and the recurrence (for method CTV and TV, recurrences were classified
in-field if more than 95% of their volume were inside the volume of interest, marginal if the intersection was
between 20-95% and outfield otherwise); and
methodCOM
was based on the position of the Centre Of Mass of the
recurrence. A dose assessment in the recurrence volume was also made.
Results:
The 2-year Kaplan-Meier locoregional recurrence incidence was 10%. Tumour recurrences occurred in 22
patients in a mean time of 16.5 ± 9.4 months resulting in 28 recurrence volumes. The percentage of in-field recurrences
for methods CTV, TV and COM was 7%, 43% and 50%, respectively. Agreement between the three methods in
characterizing individually in-field and marginal recurrences was found only in six cases. Methods CTV and COM agreed
in 14. The percentage of outfield recurrences was 29% using all methods. For local recurrences (in-field or marginal to
gross disease) the average difference between the prescribed dose and
D
98%
in the recurrence volume was -5.2 ± 3.5%
(range: -10.1%-0.9%).
Conclusions:
The classification of in-field and marginal recurrences is very dependent on the method used to
characterize recurrences. Using methods TV and COM the largest percentage of tumour recurrences occurred in-field in
tissues irradiated with high doses.
Keywords:
Head and neck tumours, Radiation therapy, Characterization of tumour recurrences, Geometric methods,
Dosimetric assessmen
Successful treatment of a free-moving abdominal mass with radiation therapy guided by cone-beam computed tomography: a case report
<p>Abstract</p> <p>Introduction</p> <p>Because tumors in the abdomen can change position, targeting these tumors for radiation therapy should be done with caution; use of daily image-guided radiation therapy is advised.</p> <p>Case presentation</p> <p>We report the case of a 72-year-old Caucasian man with recurrent mantle cell lymphoma who was referred for palliative radiation therapy for an abdominopelvic tumor. Computed tomography was used to generate images for radiation treatment planning. Comparison of those planning images with a positron emission tomography/computed tomography scan ordered during the planning period revealed that the tumor had moved from one side of the abdomen to the other during the three-day interval between scans. To account for this unusual tumor movement, we obtained a second set of planning computed tomography scans and used a Varian cone-beam computed tomography scanner with on-board imaging capability to target the tumor before each daily treatment session, leading to successful treatment and complete resolution of the mass.</p> <p>Conclusion</p> <p>Abdominal masses associated with the mesentery should be considered highly mobile; thus, radiation therapy for such masses should be used with the utmost caution. Modern radiation therapy techniques offer the ability to verify the tumor location in real time and shift the treatment ports accordingly over the course of treatment.</p