The comparison of dose distribution of different 3D conformal and conventional radiotherapy plans for gastric cancer

Izmirli M., Yilmazer G., Cakir T., Palabiyik Z. A., Nart M.

INTERNATIONAL JOURNAL OF RADIATION RESEARCH, vol.14, no.3, pp.197-203, 2016 (SCI-Expanded) identifier identifier


Aims: It was aimed to investigate postoperative conformal radiotherapy planning that provides the best target volume and the least dose for critical organs in cancers of stomach. Methods: This study was conducted on the CT simulation images of thirty patients diagnosed with gastric cancer. Target volumes and the organs at risk were contoured. AP-PA reciprocal parallel field conventional plan and three- and four-field 3D conformal plans were created using linear accelerator. Target volumes and doses consumed by organs at risk were compared by dose-volume histograms. Results: While a sufficient dose could be applied to target volumes in all plans with conformal planning, average figures showed that 95% of porta hepatis area failed to take the prescribed dose (D95) in some plans by using AP-PA reciprocal parallel zone conventional plans. The most convenient protection for spinal cord, heart and kidneys was obtained by conformal four-field technique and the liver doses were increased in conformal four-field plans but did not exceed the tolerance dose. And also, in the conventional AP-PA reciprocal parallel field plans, tolerance dose of spinal cord (4500 cGy) was exceeded. Conclusion: In this study, conformal four-field technique was superior considering target volume dose distributions, and especially spinal cord doses in all localizations and heart doses in cardia tumors. Kidney doses were also reduced in conformal four-field planning, but failed to reach statistical significance. There was a not exceeding tolerance limits dose increase in liver.