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Dosimetric comparison of different radiotherapy techniques for the treatment of Retinoblastoma

Published online by Cambridge University Press:  26 November 2020

Jyotiman Nath Open the ORCID record for Jyotiman Nath [Opens in a new window] ,
Pranjal Goswami Open the ORCID record for Pranjal Goswami [Opens in a new window] ,
Partha Pratim Medhi Open the ORCID record for Partha Pratim Medhi [Opens in a new window] ,
Gautam Sarma Open the ORCID record for Gautam Sarma [Opens in a new window] ,
Apurba Kumar Kalita Open the ORCID record for Apurba Kumar Kalita [Opens in a new window]  and
Mouchumee Bhattacharyya Open the ORCID record for Mouchumee Bhattacharyya [Opens in a new window]
Jyotiman Nath
Affiliation:
Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam, 781016, India
Pranjal Goswami
Affiliation:
Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam, 781016, India
Partha Pratim Medhi
Affiliation:
Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam, 781016, India
Gautam Sarma*
Affiliation:
Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam, 781016, India
Apurba Kumar Kalita
Affiliation:
Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam, 781016, India
Mouchumee Bhattacharyya
Affiliation:
Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam, 781016, India
*
Author for correspondence: Dr Gautam Sarma, Assistant Professor, Department of Radiation Oncology, Dr B Borooah Cancer Institute, AK Azad Road, Gopinath Nagar, Guwahati, Assam781016, India. Tel: +9678845070. E-mail: gautamsarmagmch@gmail.com
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Abstract

Aim:

This study aims to compare the dosimetric parameters among four different external beam radiotherapy techniques used for the treatment of retinoblastoma.

Materials and methods:

Computed tomography (CT) sets of five retinoblastoma patients who required radiotherapy to one globe were included. Four different plans were generated for each patient using three dimensional conformal radiotherapy (3DCRT), intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT) and VMAT using flattening filter free (VMAT-FFF) beam techniques. Plans were compared for target coverage and organs at risk (OARs) sparing.

Results:

The target coverage of planning target volume (PTV) for all the four modalities were clinically acceptable with a V95 of 95 ± 0%, 97·6 ± 1·87%, 99·3 ± 0·5% and 99·17 ± 0·45% for 3DCRT, IMRT, VMAT and VMAT-FFF respectively. The VMAT and IMRT plans had better target coverage than the 3DCRT plans (p = 0·001 and p = 0·07 respectively). IMRT and VMAT plans were also found superior to 3DCRT plans in terms of OAR sparing like brainstem, optic chiasm, brain (p < 0·05). VMAT delivered significantly lower dose to the brainstem and contralateral optic nerve in comparison to IMRT. Use of VMAT-FFF beams did not show any benefit over VMAT in target coverage and OAR sparing.

Conclusion:

VMAT should be preferred over 3DCRT and IMRT for treatment of retinoblastoma owing to better target coverage and less dose to most of the OARs. However, IMRT and VMAT should be used with caution because of the increased low dose volumes to the OARs like contralateral lens and eyeball.

Keywords

retinoblastomaradiotherapy3DCRTIMRTVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 159 - 164
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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