Radiotherapy of nasopharyngeal cancer using Rapidarc: dosimetric study of military teaching hospital Mohamed V, Morocco

The aim of the present study is to assess efficacy and efficiency of Volumetric-modulated arc therapy (VMAT) technique in treatment of nasopharyngeal cancer in our institution and to report toxicity related to this technique. Between June 2013 and January 2015, thirty-two patients with non metastati...

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Bibliographic Details
Published in:	BMC research notes Vol. 10; no. 1; p. 112
Main Authors:	Lalya, Issam, Marnouche, El Amin, Abdelhak, Maghous, Zaghba, Noha, Andaloussi, Khalid, Elmarjany, Mohamed, Baddouh, Laila, Dahmani, Keltoum, Hadadi, Khalid, Sifat, Hassan, Mansouri, Hamid
Format:	Journal Article
Language:	English
Published:	England BioMed Central 28-02-2017
Subjects:	Adult Dermatitis - etiology Female Hearing Loss - etiology Hospitals, Military Hospitals, Teaching Humans Male Middle Aged Morocco Mucositis - etiology Nasopharyngeal Neoplasms - radiotherapy Radiometry - methods Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Intensity-Modulated - adverse effects Radiotherapy, Intensity-Modulated - methods Retrospective Studies Treatment Outcome Xerostomia - etiology Volumetric-modulated arc therapy Intensity-modulated radiotherapy Nasopharyngeal cancer
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Summary:	The aim of the present study is to assess efficacy and efficiency of Volumetric-modulated arc therapy (VMAT) technique in treatment of nasopharyngeal cancer in our institution and to report toxicity related to this technique. Between June 2013 and January 2015, thirty-two patients with non metastatic nasopharyngeal cancer were curatively treated using VMAT Rapidarc. Dose prescription was performed using two different schedules, it consisted of either simultaneous integrated boost or simultaneous modulated accelerated radiation therapy delivering 70 Gy in 35 fractions and 69.96 in 33 fractions respectively. The choice was leaved at the discretion of the treating physician. The optimization process was performed by Eclipse software version 10.0 (Varian Medical Systems), using PRO algorithm (Progressive resolutive optimisation) version 3. Data was collected from dose-volume histograms for both planning target volumes (PTV) and organs at risk (OAR). We calculated the homogeneity index and the conformity index as well as the number of monitor units MU and the treatment delivery time. We also reported acute and late toxicity related to radiation therapy. For the PTV high risk (HR), intermediate risk (PTV IR) and low risk (LR) the D95% was 97.21 ± 1.5, 97.5 ± 3.3 and 97.10 ± 6.86 respectively. Whereas, The D5% was 104.6 ± 2.16, 103.8 ± 2.1 and 100.89 ± 7.26. The CI for PTV HR was 0.98 ± 0.02 and the HI was 0.08 ± 0.02. The mean treatment delivery time was 2.3 ± 0.2, and the mean MU number was 527.6 ± 131.4. Grade 4 toxicity was not reported in any case. Grade 3 xerostomia was observed in only 3(9.4%) patients and no patients developed grade 3 hearing loss. Our results confirmed the abilities of VMAT to provide excellent coverage of target volumes while sparing OAR especially the nervous structures and salivary glands.
ISSN:	1756-0500 1756-0500
DOI:	10.1186/s13104-017-2430-2