Evaluation of spatial correlation of external beam radiotherapy and interstitial brachytherapy with deformable image registration (DIR)-based dose summation in early head and neck squamous cell carcinoma.

IF 1.1 4区医学 Q4 ONCOLOGY

Journal of Contemporary Brachytherapy Pub Date : 2025-04-01 Epub Date: 2025-05-09 DOI:10.5114/jcb.2025.151519

Ashutosh Mukherji, Sambit S Nanda, Shubham Dokania, Sanju Sanju, Ajay K Choubey, Ninad H Patil, Kaushik Kashyap, Ajay S Krishnan, Pritam Mondal, Satyajit Pradhan

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引用次数: 0

Abstract

Purpose: Oral cavity squamous cell carcinoma (SCC) is conventionally treated with surgery followed by adjuvant radiation therapy. Multiple studies have demonstrated clinical utility of interstitial brachytherapy (BT) alone or external beam radiotherapy (EBRT) with BT boost for T1-T2N0 cancers of lip and buccal mucosa. In case of combined EBRT and BT, dose summation and optimizing doses received by planning target volume (PTV) and organs at risk (OARs) remains challenging.The aim of this study was to generate and evaluate dosimetric parameters of PTV and OARs as a sum of high-dose-rate (HDR)-BT boost and EBRT in early T1-T2N0 cancers of lip and buccal mucosa, using deformable image registration (DIR) software (Velocity^®). 2 Gy equivalent dose (EQD₂) calculated manually (EQD₂-D₉₀ BT + EQD₂-D₉₈ EBRT) was compared with that estimated using DIR.

Material and methods: An analysis was performed in patients with histopathologically proven T1-T2N0 SCC of lip and buccal mucosa, who underwent interstitial BT boost followed by EBRT. Planning computed tomography (CT) images and respective treatment plans of both BT and EBRT were imported into Velocity^® software, and DIR was employed to fuse these images for all patients. A synthetic plan incorporating both plans was generated. Dosimetric parameters of both PTV and OAR (mandible) were analyzed.

Results: This study included a total of 10 patients (cT1N0: n = 6, and cT2N0: n = 4), with median age of 57 years (range, 30-69 years) and male : female ratio of 7 : 3. The median dose to PTV using HDR-BT was 21 Gy (range, 20-21 Gy), delivered in 5-6 fractions, 3.5-4 Gy per fraction. The median dose to PTV using EBRT was 44 Gy (range, 40-46 Gy), delivered in 20-23 fractions, 1.8-2 Gy per fraction.

Conclusions: DIR software-based dose summation provides accurate dose delivery to target and OARs. If performed prospectively, it can potentially enable optimization of limiting the doses to critical OARs, thus, reducing post-RT morbidity.

查看原文本刊更多论文

基于形变图像配准（DIR）剂量总和的早期头颈部鳞状细胞癌外照射与间质近距离放疗的空间相关性评价。

目的：口腔鳞状细胞癌（SCC）的常规治疗方法是手术配合辅助放疗。多项研究已经证明了间质近距离放疗（BT）或外束放疗（EBRT）联合BT增强治疗唇部和颊部T1-T2N0型肿瘤的临床应用价值。在EBRT和BT联合治疗的情况下，通过规划靶体积（PTV）和危险器官（OARs）来估算和优化剂量仍然具有挑战性。本研究的目的是使用可变形图像配准（DIR）软件（Velocity®）生成和评估PTV和OARs的剂量学参数，作为高剂量率(HDR)-BT增强和EBRT在早期T1-T2N0唇部和口腔粘膜癌中的总和。手工计算的2 Gy当量剂量（EQD2- d90 BT + EQD2- d98 EBRT）与使用DIR估计的剂量进行比较。材料和方法：对组织病理学证实的唇部和颊部粘膜T1-T2N0鳞状细胞癌患者进行分析，这些患者接受间质性BT增强和EBRT治疗。将计划的CT图像以及BT和EBRT各自的治疗方案导入Velocity®软件，并使用DIR对所有患者融合这些图像。合并了这两种方案的综合方案产生了。分析PTV和OAR（下颌骨）的剂量学参数。结果：本研究共纳入10例患者（cT1N0: n = 6, cT2N0: n = 4），中位年龄57岁（范围30-69岁），男女比例为7:3。HDR-BT给PTV的中位剂量为21 Gy（范围20-21 Gy），分5-6次给药，每次3.5-4 Gy。使用EBRT给PTV的中位剂量为44 Gy（范围40-46 Gy），分20-23次给药，每次1.8-2 Gy。结论：基于DIR软件的剂量总和提供了准确的剂量传递给靶标和OARs。如果前瞻性地进行，它可以潜在地优化将剂量限制在关键的OARs，从而减少放疗后的发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.40

自引率

14.30%

发文量

审稿时长

16 weeks

期刊介绍： The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.