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La radiologia medica

, Volume 120, Issue 3, pp 324–328 | Cite as

Parotid glands in whole-brain radiotherapy: 2D versus 3D technique for no sparing or sparing

  • Marianna Trignani
  • Domenico GenovesiEmail author
  • Annamaria Vinciguerra
  • Angelo Di Pilla
  • Antonietta Augurio
  • Monica Di Tommaso
  • Giampiero Ausili Cèfaro
  • Marta Di Nicola
Radiotherapy

Abstract

Purpose

Whole-brain radiotherapy is performed as standard therapy in patients with multiple brain metastases and in patients with more favourable prognosis such as lymphoma and small-cell lung carcinoma in the prophylactic setting. Because of the prognosis and the total prescribed dose, the parotid glands are not usually regarded as an organ at risk in whole-brain radiotherapy. Long-term survival can be expected in some of these patients and late toxicity can be observed, becoming essential to evaluate organs at risk, particularly the parotid glands even in metastatic patients. We compared the 2D with 3D technique to evaluate parotid glands involvement and received dose, and coverage of the clinical target volume.

Materials and methods

Seven patients were considered. The prescribed dose was 30 Gy in ten fractions. On the same day and with the same set-up, all the treatment planning were performed using a 2D and 3D technique. A treatment plan was performed following same technical characteristics as the 2D technique. The parotid glands and whole brain were delineated. Dose–volume statistics were analysed.

Results

Dose–volume histograms of the parotid glands showed that 2/7 patients (28 %) received a mean dose >20 Gy. We found a lack of coverage of the clinical target volume in 6/7 patients.

Conclusions

Planning whole-brain radiotherapy with only the 2D technique involves a risk of including parotid glands in the field and not covering the clinical target volume. The 3D technique should be systematically performed and the parotid glands should be regarded as an organ at risk in whole-brain radiotherapy.

Keywords

Whole-brain radiotherapy Parotid gland Computed tomography 

Notes

Conflict of interest

Marianna Trignani, Domenico Genovesi, Annamaria Vinciguerra, Angelo Di Pilla, Antonietta Augurio, Monica Di Tommaso, Giampiero Ausili Cèfaro, Marta Di Nicola declare no conflict of interest.

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Copyright information

© Italian Society of Medical Radiology 2014

Authors and Affiliations

  • Marianna Trignani
    • 1
  • Domenico Genovesi
    • 1
    Email author
  • Annamaria Vinciguerra
    • 1
  • Angelo Di Pilla
    • 1
  • Antonietta Augurio
    • 1
  • Monica Di Tommaso
    • 1
  • Giampiero Ausili Cèfaro
    • 1
  • Marta Di Nicola
    • 2
  1. 1.Department of Radiation OncologyG. D’Annunzio University, SS. Annunziata HospitalChietiItaly
  2. 2.Laboratory of Biostatistics, Department of Biomedical ScienceG. D’Annunzio UniversityChietiItaly

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