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Year : 2013  |  Volume : 9  |  Issue : 3  |  Page : 422-429

Forward versus inverse planning in oropharyngeal cancer: A comparative study using physical and biological indices

1 Department of Radiation Oncology, Valavadi Narayanaswamy Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India
2 Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bangalore, India
3 Department of Physics, PSG College of Technology, Coimbatore, India
4 Department of Physics, Bharathiar University, Coimbatore, India

Correspondence Address:
T Sundaram
V. N. Cancer Centre, G. Kuppuswamy Naidu Memorial Hospital, Coimbatore - 641 037
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Source of Support: None, Conflict of Interest: None

PMID: 24125977

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Context: Possible benefits of inverse planning. Aims: To analyze possible benefits of inverse planning intensity modulated radiation therapy (IMRT) over field-in-field 3D conformal radiation therapy (FIF-3DCRT) and to evaluate the differences if any, between low (6 Million Volts) and high energy (15 Million Volts) IMRT plans. Materials and Methods: Ten patients with squamous cell carcinoma of oropharynx, previously treated with 6 MV step and shoot IMRT were studied. V 100 , V 33 , V 66 , mean dose and normal tissue complication probabilities (NTCP) were evaluated for parotid glands. Maximum dose and NTCP were the parameters for spinal cord. Statistical Analysis Used: A two-tailed t-test was applied to analyze statistical significance between the different techniques. Results: For combined parotid gland, a reduction of 4.374 Gy, 9.343 Gy and 7.883 Gy were achieved for D 100 , D 66 and D 33 , respectively in 6 MV-IMRT when compared with FIF-3DCRT. Spinal cord sparing was better in 6 MV-IMRT (40.963 ± 2.650), with an average reduction of maximum spinal cord dose by 7.355 Gy from that using the FIF-3DCRT technique. The uncomplicated tumor control probabilities values were higher in IMRT plans thus leading to a possibility of dose escalation. Conclusions: Though low-energy IMRT is the preferred choice for treatment of oropharyngeal cancers, FIF-3DCRT must be given due consideration as a second choice for its well established advantages over traditional conventioan technique.

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