IMRT for gastric cancer – pro
Compared with the conformal plans, oncologists frequently preferred IMRT plans when using dose-volume histogram data. The advantages of IMRT plans include both improved planning target volume coverage and improved sparing of critical organs.However, organ motion during breathing is a problem for IMRT planning and accuracy. A recent study found that: “When compared with either AP/PA or 3-field plans, IMRT significantly reduced the volume exceeding the threshold dose of the liver and at least one kidney. Target coverage with IMRT was excellent, with 98±1% of the target receiving 100% of the dose. Compared with AP/PA and 3-field plans, IMRT plans had a greater percentage of target receiving the prescribed dose, but also a greater volume receiving >110% of the dose.” It concluded tha more study is needed: “In summary, IMRT offers improved sparing of normal structures, allowing a dose of 50.4 Gy to be delivered to the PTV. In this small series of patients, treatment was well tolerated with acceptable toxicity, seemingly improved as compared with the Intergroup trial. IMRT in the treatment of gastric cancer warrants further study.”
Milano, M T, Garofalo, M C, Chmura, S J, Farrey, K, Rash, C, Heimann, R, Jani, A B
Intensity-modulated radiation therapy in the treatment of gastric cancer: early clinical outcome and dosimetric comparison with conventional techniques
Br J Radiol 2006 79: 497-503
Petra Wieland et al, IMRT for postoperative treatment of gastric cancer: covering large target volumes in the upper abdomen: a comparison of a step-and-shoot and an arc therapy approach, International Journal of Radiation Oncology*Biology*Physics
Volume 59, Issue 4, 15 July 2004, Pages 1236-1244