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Adaptive Radiation Therapy in Intensity-Modulated Radiation Therapy for Head and Neck Cancer

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Intensity-Modulated Radiation Therapy

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Abstract

The term adaptive radiation therapy (ART) refers to an approach to detecting and correcting the effects of variations in tumors and normal tissues between RT sessions via online or offline modification of original treatment plans. The term image-guided radiation therapy (IGRT) refers to the first component of ART, that is, the detection of changes. The ultimate intent of ART, to appropriately modify a radiation treatment plan to account for temporal changes in anatomy, is distinct from that of IGRT. Ideally, ART would involve imaging the target areas of interest while the patient is in a room used for treatment and sending the resultant in-room volumetric images to a treatment-planning system, where a new treatment plan can be created to account for the current anatomy and sent back to the treatment machine for delivery, either immediately (“online correction”) or during later treatments (“offline correction”). In treatment of head and neck cancer, most anatomic changes take place gradually during the first few weeks of treatment, and thus, offline ART may be the more practical approach in most cases. Whether online or offline, current ART strategies remain labor- and resource-intensive. With the development of new technology such as deformable image registration, offline ART has become feasible for clinical use. The dosimetric advantage of ART for reducing the dose to the various organs at risk (e.g., the parotid glands and spinal cord in head and neck cancer) over the course of treatment is readily apparent. Several prospective studies have demonstrated the feasibility and dosimetric advantages of ART for head and neck cancer. However, because implementation of ART can be costly in terms of new equipment and staffing, it is important to demonstrate that the dosimetric advantages of ART can translate into clinical benefit.

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References

  1. Pow EH, Kwong DL, McMillan AS et al (2006) Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys 66:981–991

    Article  PubMed  Google Scholar 

  2. Kam MK, Leung SF, Zee B et al (2007) Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol 25:4873–4879

    Article  PubMed  Google Scholar 

  3. Lee N, Xia P, Quivey JM et al (2002) Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 53:12–22

    Article  PubMed  Google Scholar 

  4. Lee N, Harris J, Garden AS et al (2009) Intensity-modulated radiation therapy with or without chemotherapy for nasopharyngeal carcinoma: radiation therapy oncology group phase II trial 0225. J Clin Oncol 27:3684–3690

    Article  PubMed Central  PubMed  Google Scholar 

  5. Lee SW, Back GM, Yi BY et al (2006) Preliminary results of a phase I/II study of simultaneous modulated accelerated radiotherapy for nondisseminated nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 65:152–160

    Article  PubMed  Google Scholar 

  6. Wolden SL, Chen WC, Pfister DG, Kraus DH, Berry SL, Zelefsky MJ (2006) Intensity-modulated radiation therapy (IMRT) for nasopharynx cancer: update of the Memorial Sloan-Kettering experience. Int J Radiat Oncol Biol Phys 64:57–62

    Article  PubMed  Google Scholar 

  7. Barker JL Jr, Garden AS, Ang KK et al (2004) Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT/linear accelerator system. Int J Radiat Oncol Biol Phys 59:960–970

    Article  PubMed  Google Scholar 

  8. Nishi T, Nishimura Y, Shibata T et al (2013) Volume and dosimetric changes and initial clinical experience of a two-step adaptive intensity modulated radiation therapy (IMRT) scheme for head and neck cancer. Radiother Oncol 106:85–89

    Article  PubMed  Google Scholar 

  9. Nishimura Y, Nakamatsu K, Shibata T et al (2005) Importance of the initial volume of parotid glands in xerostomia for patients with head and neck cancers treated with IMRT. Jpn J Clin Oncol 35:375–379

    Article  PubMed  Google Scholar 

  10. Cannon DM, Lee NY (2008) Recurrence in region of spared parotid gland after definitive intensity-modulated radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 70:660–665

    Article  PubMed  Google Scholar 

  11. Nishimura Y, Shibata T, Nakamatsu K et al (2010) A two-step intensity-modulated radiation therapy method for nasopharyngeal cancer: the Kinki University experience. Jpn J Clin Oncol 40:130–138

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  13. Yan D, Vicini F, Wong J et al (1997) Adaptive radiation therapy. Phys Med Biol 42:123–132

    Article  CAS  PubMed  Google Scholar 

  14. Suzuki M, Nishimura Y, Nakamatsu K et al (2006) Analysis of interfractional set-up errors and intrafractional organ motions during IMRT for head and neck tumors to define an appropriate planning target volume (PTV)- and planning organs at risk volume (PRV)-margins. Radiother Oncol 78:283–290

    Article  PubMed  Google Scholar 

  15. Grégoire V, Jeraj R, Lee JA, O’Sullivan B (2012) Radiotherapy for head and neck tumours in 2012 and beyond: conformal, tailored, and adaptive? Lancet Oncol 13:e292–e300

    Article  PubMed  Google Scholar 

  16. Schwartz DL, Dong L (2011) Adaptive radiation therapy for head and neck cancer-can an old goal evolve into a new standard? J Oncol 2011:1–13. pii: 690595. doi:10.1155/2011/690595

  17. Schwartz DL (2012) Current progress in adaptive radiation therapy for head and neck cancer. Curr Oncol Rep 14(2):139–147

    Article  CAS  PubMed  Google Scholar 

  18. Hunter KU, Fernandes LL, Vineberg KA et al (2013) Parotid glands dose-effect relationships based on their actually delivered doses: implications for adaptive replanning in radiation therapy of head-and-neck cancer. Int J Radiat Oncol Biol Phys 87:676–682

    Article  PubMed Central  PubMed  Google Scholar 

  19. Schwartz DL, Garden AS, Thomas J et al (2012) Adaptive radiotherapy for head-and-neck cancer: initial clinical outcomes from a prospective trial. Int J Radiat Oncol Biol Phys 83:986–993

    Article  PubMed Central  PubMed  Google Scholar 

  20. Wu Q, Chi Y, Chen PY et al (2009) Adaptive replanning strategies accounting for shrinkage in head and neck IMRT. Int J Radiat Oncol Biol Phys 75:924–932

    Article  PubMed  Google Scholar 

  21. Zhen X, Yan H, Zhou L et al (2013) Deformable image registration of CT and truncated cone-beam CT for adaptive radiation therapy. Phys Med Biol 58(22):7979–7993

    Article  PubMed  Google Scholar 

  22. Ahn PH, Chen CC, Ahn AI et al (2011) Adaptive planning in intensity-modulated radiation therapy for head and neck cancers: single-institution experience and clinical implications. Int J Radiat Oncol Biol Phys 80:677–685

    Article  PubMed  Google Scholar 

  23. Bhide SA, Davies M, Burke K et al (2010) Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: a prospective observational study. Int J Radiat Oncol Biol Phys 76:1360–1368

    Article  PubMed  Google Scholar 

  24. Kuo YC, Wu TH, Chung TS et al (2006) Effect of regression of enlarged neck lymph nodes on radiation doses received by parotid glands during intensity-modulated radiotherapy for head and neck cancer. Am J Clin Oncol 29:600–605

    Article  PubMed  Google Scholar 

  25. Duma MN, Kampfer S, Schuster T et al (2012) Adaptive radiotherapy for soft tissue changes during helical tomotherapy for head and neck cancer. Strahlenther Onkol 188:243–247

    Article  CAS  PubMed  Google Scholar 

  26. Berwouts D, Olteanu LA, Duprez F et al (2013) Three-phase adaptive dose-painting-by-numbers for head-and-neck cancer: initial results of the phase I clinical trial. Radiother Oncol 107:310–316

    Article  PubMed  Google Scholar 

  27. Zhao L, Wan Q, Zhou Y et al (2011) The role of replanning in fractionated intensity modulated radiotherapy for nasopharyngeal carcinoma. Radiother Oncol 98:23–27

    Article  PubMed  Google Scholar 

  28. Hoeben BA, Bussink J, Troost EG et al (2013) Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer. Acta Oncol 52:1257–1271

    Article  CAS  PubMed  Google Scholar 

  29. Choi W, Lee SW, Park SH et al (2010) Planning study for available dose of hypoxic tumor volume using fluorine-18-labeled fluoromisonidazole positron emission tomography for treatment of the head and neck cancer. Radiother Oncol 97:176–182

    Article  PubMed  Google Scholar 

  30. Lee NY, Mechalakos JG, Nehmeh S et al (2008) Fluorine-18-labeled fluoromisonidazole positron emission and computed tomography-guided intensity-modulated radiotherapy for head and neck cancer: a feasibility study. Int J Radiat Oncol Biol Phys 70:2–13

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Geets X, Grégoire V, Lee JA (2013) Implementation of hypoxia PET imaging in radiation therapy planning. Q J Nucl Med Mol Imag 57(3):271–282

    CAS  Google Scholar 

  32. Tachibana I, Nishimura Y, Shibata T et al (2013) A prospective clinical trial of tumor hypoxia imaging with 18F-fluoromisonidazole positron emission tomography and computed tomography (F-MISO PET/CT) before and during radiation therapy. J Radiat Res 54:1078–1084

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Lin Z, Mechalakos J, Nehmeh S et al (2008) The influence of changes in tumor hypoxia on dose-painting treatment plans based on 18F-FMISO positron emission tomography. Int J Radiat Oncol Biol Phys 70:1219–1228

    Article  PubMed Central  PubMed  Google Scholar 

  34. Nehmeh SA, Lee NY, Schroder H et al (2008) Reproducibility of intratumor distribution of 18F-fluoromisonidazole in head and neck cancer. Int J Radiat Oncol Biol Phys 70:235–242

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Christian N, Lee JA, Bol A et al (2009) The limitation of PET imaging for biological adaptive-IMRT assessed in animal models. Radiother Oncol 91:101–106

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported in part by a Grant-in-Aid for Cancer Research (H23-009, H26-090) from the Ministry of Health, Labour, and Welfare of Japan and by a Grant-in-Aid for Scientific Research (25461932) from the Ministry of Education, Culture, Sports, Science, and Technology, Japan.

Conflict of Interest Statement

The author has no conflicts to declare.

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Authors and Affiliations

  1. Department of Radiation Oncology, Kinki University Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Yasumasa Nishimura M.D., Ph.D.

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  1. Yasumasa Nishimura M.D., Ph.D.
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Correspondence to Yasumasa Nishimura M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Radiation Oncology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan

    Yasumasa Nishimura

  2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Ritsuko Komaki

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Nishimura, Y. (2015). Adaptive Radiation Therapy in Intensity-Modulated Radiation Therapy for Head and Neck Cancer. In: Nishimura, Y., Komaki, R. (eds) Intensity-Modulated Radiation Therapy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55486-8_6

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  • DOI: https://doi.org/10.1007/978-4-431-55486-8_6

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55485-1

  • Online ISBN: 978-4-431-55486-8

  • eBook Packages: MedicineMedicine (R0)

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