Beyza ÖZDEMİR ŞİRİN, Zeynep Rukiye Özge CAN

THE EFFECT OF RADIOTHERAPY TECHNIQUE ON CAROTID ARTERY DOSE IN PATIENTS WITH EARLY STAGE GLOTTIC LARYNX CANCER

ObjectiveThe aim of this study was to compare two radiotherapy (RT) techniques in early-stage glottic laryngealcancer patients in terms of radiotherapy doses to which the carotid artery was exposed. Material and MethodsIn this study, we included 10 early-stage (T1/2) glottic larynx cancer patients. Both intensity-modulatedradiotherapy (IMRT) and 3-dimensional conformalradiotherapy (3DCRT) treatment plans were prepared for each patient. Treatment volumes (CTV, PTV)were created for all patients. The entire larynx wasdescribed as CTV to include both false and true vocalcords, anterior-posterior commissures, arytenoids,aryepiglottic folds, subglottic region. The prescriptiondose was 6300-6525 cGy in 28 -29 fractions (225 cGyper fraction) to the PTV. For planning target volume(PTV), while 5-mm was added to CTV in all directions,3-mm margin was given to protect the carotid arteryand spinal cord posterolaterally. Spinal cord and carotid artery were contoured as the organs at risk (OAR).The doses of the target volumes, the OAR volumes,the homogeneity index (HI), conformity index (CI)were compared.ResultsIMRT in comparison to 3DCRT significantly reducedthe high-dose volumes (V30, V35, V50) of carotid artery (p < 0.001). However, the V10 parameter did notsignificantly decrease in any technique. CI was similar(0.9 vs. 0.9, p = 0.3) compared to 3DCRT. However,HI was significantly improved with 3DCRT (0.1 vs.0.08, p < 0.001). The maximum dose of spinal cordwas lower in 3DCRT compared to IMRT (18 Gy vs.44Gy).ConclusionIMRT is a RT technique in patients with T1/T2 glotticcancer in terms of protecting carotid artery.

ERKEN EVRE GLOTTİK LARENKS KANSERLİ HASTALARDA RADYOTERAPİ TEKNİĞİNİN KAROTİS ARTER DOZU ÜZERİNE ETKİSİ

Amaç Bu çalışmanın amacı, erken evre glottik larenks kanser tanılı hastalarda iki radyoterapi (RT) tekniğinin karotis arter dozları açısından karşılaştırılmasıdır. Gereç ve Yöntem Bu çalışmaya, 10 erken evre (T1 / 2) glottik larenks kanser tanılı hastayı dahil ettik. Her bir hasta için hem yoğunluk ayarlı radyoterapi (YART) hem de 3 boyutlu konformal radyoterapi (3BKRT) tedavi planları hazırlandı. Tüm hastalar için tedavi volümleri (CTV, PTV) oluşturuldu. Tüm larinks, gerçek ve yalancı vokal kordlar, anterior-posterior komissürler, aritenoidler, aryepiglottik kıvrımlar, subglottik bölge dahil edilecek şekilde klinik hedef volüm (CTV) olşturuldu. PTV'ye 28 -29 fraksiyonda (fraksiyon başına 225 cGy) 6300- 6525 cGy doz tanımlandı. Planlanan hedef volümü (PTV) oluşturmak için, tüm yönlerde CTV'ye 5 mm eklenirken, karotis arter ve spinal kordu korumak adına posterolateral yönde 3 mm'lik marj verildi. Spinal kord ve karotis arterler kritik organlar (OAR) olarak konturlandı. Hedef hacim dozları, OAR hacimleri, homojenlik indeksi (HI), konformite indeksi (CI) karşılaştırıldı. Bulgular 3BKRT’ye kıyasla YART, karotis arterde yüksek doz hacimlerini (V30, V35, V50) belirgin olarak düşürürken (p < 0.001), düşük doz hacimleri (V10) her iki teknikte de yüksek seyretti. Her iki teknikte de CI benzer olup (0.9 vs. 0.9, p = 0.3), HI 3BKRT’de daha iyiydi (0.1 vs. 0.08, p < 0.001). Spinal kord maksimum dozları 3BKRT’de daha düşüktü (18 Gy vs. 44Gy). Sonuç IMRT, T1 / T2 glottik kanserli hastalarda karotis arterin korunması açısından üstün bir RT tekniğidir.

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