Akademik Veri Yönetim Sistemi
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, cilt.26, sa.4, ss.1231-1238, 2021 (SCI-Expanded)
Purpose: In this study we compared the clinical and dosimetric outcomes of simultaneous integrated boost intensity
modulated radiation therapy (SIB-IMRT) and sequential
boost (SEQ-IMRT) techniques in preoperative rectal cancer
(RC).
Methods: We analyzed 67 preoperative RC patients who
received RT with Helical TomoTherapy (HT) device. 27 of
patients were irradiated with SEQ-IMRT and 40 were irradiated with SIB-IMRT technique. The primary tumor
and involved lymph nodes were simultaneously treated using the SIB-IMRT (50.4Gy/25 fraction). SEQ-IMRT delivered 45Gy/25 fractions to primary tumor (involved lymph
nodes) and 5.4Gy/3fractions to boost volume. Dosimetric
parameters, acute toxicities and 5year overal survival (OS),
disease-free survival (DFS) and local control (LC) between
two techniques were compared.
Results: In the SIB-IMRT group planning treatment volume
(PTV) homogeneity index (HI) was better than in the SEQIMRT group. PTV doses of Dmax for SEQ-IMRT group were
higher than the SIB-IMRT group (p<0.05). The bladder doses
of Dmax in the SIB-IMRT group were higher than SEQ-IMRT group (p<0.005). There were no significant differences in
other dosimetric parameters between groups. Median follow
up was 29.06 months (range 4.3-92.07) and 36.46 months
(range 8.7-79.6) in the SIB-IMRT and SEQ-IMRT groups,
respectively. No significant difference was found between
the SIB-IMRT and SEQ-IMRT groups in acute toxicity
(p=0,909). Five-year OS, DFS and LC were 73.15%, 66.75%
and 75.55% in SIB-IMRT group and 65.19%, 55.53% and
60.22% in the SEQ-IMRT group, respectively. No statically
significant differences were found between the two groups
regarding 5-year OS, DFS and LC.
Conclusions: SIB-IMRT and SEQ-IMRT tecniques provided similar outcomes for dosimetric and clinical results
for RC in HT treatment.