Skip to main content
Log in

A dosimetric comparative study between conformal and intensity modulated radiation therapy in the treatment of primary nasopharyngeal carcinomas: the Egyptian experience

  • Published:
The Chinese-German Journal of Clinical Oncology

Abstract

Objective

The study is a comparative study, the aim of which is to compare 3D conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) in treating nasopharyngeal carcinomas; dosimetrically evaluating and comparing both techniques as regard target coverage and doses to organs at risk (OAR).

Methods

Twenty patients with nasopharyngeal carcinoma were treated by 3D-CRT technique and another 20 patients were treated by IMRT. A dosimetric comparison was done by performing two plans for the same patient using Eclipse planning system (version 8.6).

Results

IMRT had a better tumor coverage and conformity index compared to 3D-CRT plans (P value of 0.001 and 0.004), respectively. As for the dose homogeneity it was also better in the IMRT plans and the reason for this was attributed to the dose inhomogeneity at the photon/electron junction in the 3D-CRT plans (P value 0.032). Also, doses received by the risk structures, particularly parotids, was significantly less in the IMRT plans than those of 3D-CRT (P value 0.001).

Conclusion

IMRT technique was clearly able to increase the dose delivery to the target volume, improve conformity and homogeneity index and spare the parotid glands in comparison to 3D-CRT technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hoppe RT, Goffinet DR, Bagshaw MA. Carcinoma of the nasopharynx. Eighteen years’ experience with megavoltage radiation therapy. Cancer, 1976, 37: 2605–2612.

    Article  PubMed  CAS  Google Scholar 

  2. Vikram B, Mishra UB, Strong EW, et al. Patterns of failure in carcinoma of the nasopharynx: I. Failure at the primary site. Int J Radiat Oncol Biol Phys, 1985, 11: 1455–1459.

    Article  PubMed  CAS  Google Scholar 

  3. Perez CA, Devineni VR, Marcial-Vega V, et al. Carcinoma of the nasopharynx: factors affecting prognosis. Int J Radiat Oncol Biol Phys, 1992, 23: 271–280.

    Article  PubMed  CAS  Google Scholar 

  4. Sanguineti G, Geara FB, Garden AS, et al. Carcinoma of the naso-pharynx treated by radiotherapy alone: determinants of local and regional control. Int J Radiat Oncol Biol Phys, 1997, 37: 985–996.

    Article  PubMed  CAS  Google Scholar 

  5. Lee AW, Law SC, Foo W, et al. Nasopharyngeal carcinoma: local control by megavoltage irradiation. Br J Radiol, 1993, 66: 528–536.

    Article  PubMed  CAS  Google Scholar 

  6. Hunt MA, Zelefsky MJ, Wolden S, et al. Treatment planning and delivery of intensity-modulated radiation therapy for primary nasopharynx cancer. Int J Radiat Oncol Biol Phys, 2001, 49: 623–632.

    Article  PubMed  CAS  Google Scholar 

  7. Huchet A, Caudry M, Belkacemi Y, et al. Volume-effect and radiotherapy. Part II: volume-effect and normal tissue. Cancer Radiother, 2003, 7: 353–362.

    Article  PubMed  CAS  Google Scholar 

  8. Goitein M, Abrams M, Rowell D, et al. Multi-dimensional treatment planning: II. Beam’s eye view, back projection, and projection through CT sections. Int J Radiat Oncol Biol Phys, 1983, 9: 789–797.

    Article  PubMed  CAS  Google Scholar 

  9. Pirzkall A, Carol M, Lohr F, et al. Comparison of intensity modulated radiotherapy with conventional conformal radiotherapy for complex shaped tumors. Int J Radiat Oncol Biol Phys, 2000, 48: 1371–1380.

    Article  PubMed  CAS  Google Scholar 

  10. Lee N, Xia P, Fischbein NJ, et al. Intensity-modulated radiation therapy for head and neck cancer: The UCSF experience focusing on target volume delineation. Int J Radiat Oncol Biol Phys, 2003, 57: 49–60.

    Article  PubMed  Google Scholar 

  11. Schoenfeld GO, Amdur RJ, Morris CG, et al. Patterns of failure and toxicity after intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys, 2008, 71: 377–385.

    Article  PubMed  Google Scholar 

  12. Chao KS, Ozyigit G, Tran BN, et al. Patterns of failure in patients receiving definitive and postoperative IMRT for head and neck cancer. Int J Radiat Oncol Biol Phys, 2003, 55: 312–321.

    Article  PubMed  Google Scholar 

  13. Bhide S, Clark C, Harrington K, et al. Intensity modulated radiothera-py improves target coverage and parotid gland sparing when delivering total mucosal irradiation in patients with squamous cell carcinoma of head and neck of unknown primary site. Med Dosim, 2007, 32: 188–195.

    Article  PubMed  Google Scholar 

  14. Eisbruch A, Ten Haken RK, Kim HM, et al. Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer. Int J Radiat Oncol Biol Phys, 1999, 45: 577–587.

    Article  PubMed  CAS  Google Scholar 

  15. Kwong DL, Wei WI, Sham JS, et al. Sensorineural hearing loss in patients treated for nasopharyngeal carcinoma: a prospective study of the effect of radiation and cisplatin treatment. Int J Radiat Oncol Biol Phys, 1996, 36: 281–289.

    Article  PubMed  CAS  Google Scholar 

  16. Pan CC, Eisbruch A, Lee JS, et al. Prospective study of inner ear radiation dose and hearing loss in head-and-neck cancer patients. Int J Radiat Oncol Biol Phys, 2005, 61: 1393–1402.

    Article  PubMed  Google Scholar 

  17. Rosenthal DI, Chambers MS, Fuller CD, et al. Beam path toxicities to non-target structures during intensity-modulated radiation therapy for head and neck cancer. Int J Radiat Oncol Biol Phys, 2008, 72: 747–755.

    Article  PubMed  Google Scholar 

  18. Kristensen CA, Kjaer-Kristoffersen F, Sapru W, et al. Nasopharyngeal carcinoma. Treatment planning with IMRT and 3D conformal radiotherapy. Acta Oncol, 2007, 46: 214–220.

    Article  PubMed  Google Scholar 

  19. Tomita N, Kodaira T, Tachibana H, et al. A comparison of radiation treatment plans using IMRT wit helical tomoherapy and 3D conformal radiotherapy for nasal natural killer/T-cell lymphoma. Br J Radiol, 2009, 82: 756–763.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karim N. Mashhour.

Rights and permissions

Reprints and permissions

About this article

Cite this article

El-Ghoneimy, E.G., Hassan, M.A., El-Bestar, M.F. et al. A dosimetric comparative study between conformal and intensity modulated radiation therapy in the treatment of primary nasopharyngeal carcinomas: the Egyptian experience. Chin. -Ger. J. Clin. Oncol. 11, 626–631 (2012). https://doi.org/10.1007/s10330-012-1040-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10330-012-1040-7

Key words

Navigation