Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept

Background and purpose: Conventional elective neck irradiation (ENI) in head and neck cancer consists of radiotherapy (RT) to the regional lymph node (LN) levels contoured on computed tomography. Hybrid Magnetic Resonance (MR) - RT modalities, such as combined magnetic resonance imaging - linear acc...

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Autores principales:	Floris C.J. Reinders, Tristan C.F. van Heijst, Joel Mases, Chris H.J. Terhaard, Patricia A.H. Doornaert, Marielle E.P. Philippens, Cornelis P.J. Raaijmakers
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Magnetic resonance imaging Lymph nodes Radiotherapy Squamous cell carcinoma of head and neck Head and neck neoplasms Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/d0ee3160ca80450abea5c4ef2d0d1655
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spelling	oai:doaj.org-article:d0ee3160ca80450abea5c4ef2d0d16552021-11-12T04:42:22ZMagnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept2405-631610.1016/j.phro.2021.10.006https://doaj.org/article/d0ee3160ca80450abea5c4ef2d0d16552021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405631621000634https://doaj.org/toc/2405-6316Background and purpose: Conventional elective neck irradiation (ENI) in head and neck cancer consists of radiotherapy (RT) to the regional lymph node (LN) levels contoured on computed tomography. Hybrid Magnetic Resonance (MR) - RT modalities, such as combined magnetic resonance imaging - linear accelerators (MRLs), might enable new ENI strategies in which individual non-suspect lymph nodes (i-LNs) are targeted. In this treatment planning study, new MR-based strategies targeting i-LNs (i-ENI) were compared to conventional treatment. Materials and methods: All i-LNs were delineated on MR images of ten retrospectively selected patients with T2-4aN0M0 laryngeal cancer. Three strategies were considered. Strategy A: Conventional ENI delivered with a conventional linear accelerator (35x 1.55 Gy). Strategy B: MRL-based i-ENI (35x 1.55 Gy) to the individual lymph nodes including a background dose to the conventional elective neck volumes (35x 1.03 Gy). Strategy C: Same as Strategy B, but without background dose. In all plans the dose prescription to the primary tumor was 35x 2 Gy. Mean dose (Dmean) reductions in the organs at risk (OAR) were compared using the Wilcoxon signed rank test. Results: Compared to conventional ENI (strategy A), significant Dmean reductions of 6.0 Gy and 8.0 Gy were observed in the submandibular glands, of 9.4 Gy and 13 Gy in the carotid arteries and of 9.9 Gy and 19.4 Gy in the thyroid for strategy B and C, respectively. Large inter-patient variations of Dmean reductions were observed in all OARs. Conclusion: MRL-based i-ENI is a new promising concept that could reduce the mean dose to OARs in the neck significantly for patients with laryngeal cancer.Floris C.J. ReindersTristan C.F. van HeijstJoel MasesChris H.J. TerhaardPatricia A.H. DoornaertMarielle E.P. PhilippensCornelis P.J. RaaijmakersElsevierarticleMagnetic resonance imagingLymph nodesRadiotherapySquamous cell carcinoma of head and neckHead and neck neoplasmsMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENPhysics and Imaging in Radiation Oncology, Vol 20, Iss , Pp 76-81 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Magnetic resonance imaging Lymph nodes Radiotherapy Squamous cell carcinoma of head and neck Head and neck neoplasms Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Magnetic resonance imaging Lymph nodes Radiotherapy Squamous cell carcinoma of head and neck Head and neck neoplasms Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Floris C.J. Reinders Tristan C.F. van Heijst Joel Mases Chris H.J. Terhaard Patricia A.H. Doornaert Marielle E.P. Philippens Cornelis P.J. Raaijmakers Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept
description	Background and purpose: Conventional elective neck irradiation (ENI) in head and neck cancer consists of radiotherapy (RT) to the regional lymph node (LN) levels contoured on computed tomography. Hybrid Magnetic Resonance (MR) - RT modalities, such as combined magnetic resonance imaging - linear accelerators (MRLs), might enable new ENI strategies in which individual non-suspect lymph nodes (i-LNs) are targeted. In this treatment planning study, new MR-based strategies targeting i-LNs (i-ENI) were compared to conventional treatment. Materials and methods: All i-LNs were delineated on MR images of ten retrospectively selected patients with T2-4aN0M0 laryngeal cancer. Three strategies were considered. Strategy A: Conventional ENI delivered with a conventional linear accelerator (35x 1.55 Gy). Strategy B: MRL-based i-ENI (35x 1.55 Gy) to the individual lymph nodes including a background dose to the conventional elective neck volumes (35x 1.03 Gy). Strategy C: Same as Strategy B, but without background dose. In all plans the dose prescription to the primary tumor was 35x 2 Gy. Mean dose (Dmean) reductions in the organs at risk (OAR) were compared using the Wilcoxon signed rank test. Results: Compared to conventional ENI (strategy A), significant Dmean reductions of 6.0 Gy and 8.0 Gy were observed in the submandibular glands, of 9.4 Gy and 13 Gy in the carotid arteries and of 9.9 Gy and 19.4 Gy in the thyroid for strategy B and C, respectively. Large inter-patient variations of Dmean reductions were observed in all OARs. Conclusion: MRL-based i-ENI is a new promising concept that could reduce the mean dose to OARs in the neck significantly for patients with laryngeal cancer.
format	article
author	Floris C.J. Reinders Tristan C.F. van Heijst Joel Mases Chris H.J. Terhaard Patricia A.H. Doornaert Marielle E.P. Philippens Cornelis P.J. Raaijmakers
author_facet	Floris C.J. Reinders Tristan C.F. van Heijst Joel Mases Chris H.J. Terhaard Patricia A.H. Doornaert Marielle E.P. Philippens Cornelis P.J. Raaijmakers
author_sort	Floris C.J. Reinders
title	Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept
title_short	Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept
title_full	Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept
title_fullStr	Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept
title_full_unstemmed	Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept
title_sort	magnetic resonance guided elective neck irradiation targeting individual lymph nodes: a new concept
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/d0ee3160ca80450abea5c4ef2d0d1655
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Magnetic resonance guided elective neck irradiation targeting individual lymph nodes: A new concept

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