Head and Neck Margin Reduction With Adaptive Radiation TherapyCitation formats

  • External authors:
  • Simon van Kranen
  • Olga Hamming-Vrieze
  • Annelisa Wolf
  • Eugène Damen
  • Jan Jakob Sonke

Standard

Head and Neck Margin Reduction With Adaptive Radiation Therapy : Robustness of Treatment Plans Against Anatomy Changes. / van Kranen, Simon; Hamming-Vrieze, Olga; Wolf, Annelisa; Damen, Eugène; van Herk, Marcel; Sonke, Jan Jakob.

In: International Journal of Radiation Oncology Biology Physics, Vol. 96, No. 3, 01.11.2016, p. 653-660.

Research output: Contribution to journalArticle

Harvard

van Kranen, S, Hamming-Vrieze, O, Wolf, A, Damen, E, van Herk, M & Sonke, JJ 2016, 'Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes', International Journal of Radiation Oncology Biology Physics, vol. 96, no. 3, pp. 653-660. https://doi.org/10.1016/j.ijrobp.2016.07.011

APA

van Kranen, S., Hamming-Vrieze, O., Wolf, A., Damen, E., van Herk, M., & Sonke, J. J. (2016). Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes. International Journal of Radiation Oncology Biology Physics, 96(3), 653-660. https://doi.org/10.1016/j.ijrobp.2016.07.011

Vancouver

van Kranen S, Hamming-Vrieze O, Wolf A, Damen E, van Herk M, Sonke JJ. Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes. International Journal of Radiation Oncology Biology Physics. 2016 Nov 1;96(3):653-660. https://doi.org/10.1016/j.ijrobp.2016.07.011

Author

van Kranen, Simon ; Hamming-Vrieze, Olga ; Wolf, Annelisa ; Damen, Eugène ; van Herk, Marcel ; Sonke, Jan Jakob. / Head and Neck Margin Reduction With Adaptive Radiation Therapy : Robustness of Treatment Plans Against Anatomy Changes. In: International Journal of Radiation Oncology Biology Physics. 2016 ; Vol. 96, No. 3. pp. 653-660.

Bibtex

@article{5f441a674d0645428472743cc055e3fd,
title = "Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes",
abstract = "Purpose We set out to investigate loss of target coverage from anatomy changes in head and neck cancer patients as a function of applied safety margins and to verify a cone beam computed tomography (CBCT)–based adaptive strategy with an average patient anatomy to overcome possible target underdosage. Methods and Materials For 19 oropharyngeal cancer patients, volumetric modulated arc therapy treatment plans (2 arcs; simultaneous integrated boost, 70 and 54.25 Gy; 35 fractions) were automatically optimized with uniform clinical target volume (CTV)–to–planning target volume margins of 5, 3, and 0 mm. We applied b-spline CBCT–to–computed tomography (CT) deformable registration to allow recalculation of the dose on modified CT scans (planning CT deformed to daily CBCT following online positioning) and dose accumulation in the planning CT scan. Patients with deviations in primary or elective CTV coverage >2 Gy were identified as candidates for adaptive replanning. For these patients, a single adaptive intervention was simulated with an average anatomy from the first 10 fractions. Results Margin reduction from 5 mm to 3 mm to 0 mm generally led to an organ-at-risk (OAR) mean dose (Dmean) sparing of approximately 1 Gy/mm. CTV shrinkage was mainly seen in the elective volumes (up to 10{\%}), likely related to weight loss. Despite online repositioning, substantial systematic errors were present (>3 mm) in lymph node CTV, the parotid glands, and the larynx. Nevertheless, the average increase in OAR dose was small: maximum of 1.2 Gy (parotid glands, Dmean) for all applied margins. Loss of CTV coverage >2 Gy was found in 1, 3, and 7 of 73 CTVs, respectively. Adaptive intervention in 0-mm plans substantially improved coverage: in 5 of 7 CTVs (in 6 patients) to 2 Gy in 0-mm plans may be identified early in treatment using dose accumulation. A single intervention with an average anatomy derived from CBCT effectively mitigates discrepancies.",
author = "{van Kranen}, Simon and Olga Hamming-Vrieze and Annelisa Wolf and Eug{\`e}ne Damen and {van Herk}, Marcel and Sonke, {Jan Jakob}",
year = "2016",
month = "11",
day = "1",
doi = "10.1016/j.ijrobp.2016.07.011",
language = "English",
volume = "96",
pages = "653--660",
journal = "International Journal of Radiation: Oncology - Biology - Physics",
issn = "0360-3016",
publisher = "Elsevier BV",
number = "3",

}

RIS

TY - JOUR

T1 - Head and Neck Margin Reduction With Adaptive Radiation Therapy

T2 - Robustness of Treatment Plans Against Anatomy Changes

AU - van Kranen, Simon

AU - Hamming-Vrieze, Olga

AU - Wolf, Annelisa

AU - Damen, Eugène

AU - van Herk, Marcel

AU - Sonke, Jan Jakob

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Purpose We set out to investigate loss of target coverage from anatomy changes in head and neck cancer patients as a function of applied safety margins and to verify a cone beam computed tomography (CBCT)–based adaptive strategy with an average patient anatomy to overcome possible target underdosage. Methods and Materials For 19 oropharyngeal cancer patients, volumetric modulated arc therapy treatment plans (2 arcs; simultaneous integrated boost, 70 and 54.25 Gy; 35 fractions) were automatically optimized with uniform clinical target volume (CTV)–to–planning target volume margins of 5, 3, and 0 mm. We applied b-spline CBCT–to–computed tomography (CT) deformable registration to allow recalculation of the dose on modified CT scans (planning CT deformed to daily CBCT following online positioning) and dose accumulation in the planning CT scan. Patients with deviations in primary or elective CTV coverage >2 Gy were identified as candidates for adaptive replanning. For these patients, a single adaptive intervention was simulated with an average anatomy from the first 10 fractions. Results Margin reduction from 5 mm to 3 mm to 0 mm generally led to an organ-at-risk (OAR) mean dose (Dmean) sparing of approximately 1 Gy/mm. CTV shrinkage was mainly seen in the elective volumes (up to 10%), likely related to weight loss. Despite online repositioning, substantial systematic errors were present (>3 mm) in lymph node CTV, the parotid glands, and the larynx. Nevertheless, the average increase in OAR dose was small: maximum of 1.2 Gy (parotid glands, Dmean) for all applied margins. Loss of CTV coverage >2 Gy was found in 1, 3, and 7 of 73 CTVs, respectively. Adaptive intervention in 0-mm plans substantially improved coverage: in 5 of 7 CTVs (in 6 patients) to 2 Gy in 0-mm plans may be identified early in treatment using dose accumulation. A single intervention with an average anatomy derived from CBCT effectively mitigates discrepancies.

AB - Purpose We set out to investigate loss of target coverage from anatomy changes in head and neck cancer patients as a function of applied safety margins and to verify a cone beam computed tomography (CBCT)–based adaptive strategy with an average patient anatomy to overcome possible target underdosage. Methods and Materials For 19 oropharyngeal cancer patients, volumetric modulated arc therapy treatment plans (2 arcs; simultaneous integrated boost, 70 and 54.25 Gy; 35 fractions) were automatically optimized with uniform clinical target volume (CTV)–to–planning target volume margins of 5, 3, and 0 mm. We applied b-spline CBCT–to–computed tomography (CT) deformable registration to allow recalculation of the dose on modified CT scans (planning CT deformed to daily CBCT following online positioning) and dose accumulation in the planning CT scan. Patients with deviations in primary or elective CTV coverage >2 Gy were identified as candidates for adaptive replanning. For these patients, a single adaptive intervention was simulated with an average anatomy from the first 10 fractions. Results Margin reduction from 5 mm to 3 mm to 0 mm generally led to an organ-at-risk (OAR) mean dose (Dmean) sparing of approximately 1 Gy/mm. CTV shrinkage was mainly seen in the elective volumes (up to 10%), likely related to weight loss. Despite online repositioning, substantial systematic errors were present (>3 mm) in lymph node CTV, the parotid glands, and the larynx. Nevertheless, the average increase in OAR dose was small: maximum of 1.2 Gy (parotid glands, Dmean) for all applied margins. Loss of CTV coverage >2 Gy was found in 1, 3, and 7 of 73 CTVs, respectively. Adaptive intervention in 0-mm plans substantially improved coverage: in 5 of 7 CTVs (in 6 patients) to 2 Gy in 0-mm plans may be identified early in treatment using dose accumulation. A single intervention with an average anatomy derived from CBCT effectively mitigates discrepancies.

UR - http://www.scopus.com/inward/record.url?scp=84990862364&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2016.07.011

DO - 10.1016/j.ijrobp.2016.07.011

M3 - Article

AN - SCOPUS:84990862364

VL - 96

SP - 653

EP - 660

JO - International Journal of Radiation: Oncology - Biology - Physics

JF - International Journal of Radiation: Oncology - Biology - Physics

SN - 0360-3016

IS - 3

ER -