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Dose Verification On the Variation of Target Volume and Organ at Risk in Preradiation Chemotherapy IMRT for Nasopharyngeal Cancer

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X Zhang

X Zhang*, L Kong , J Wang , W Hu , Z Chen , Fudan university shanghai cancer center, Shanghai, shanghai


SU-E-T-287 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: To quantify the target volume and organ at risk of nasopharyngeal carcinoma (NPC) patients with preradiation chemotherapy based on CT scanned during intensity-modulated radiotherapy (IMRT), and recalculate the dose distribution.
Methods: Seven patients with NPC and preradiation chemotherapy, treated with IMRT (35 to 37 fractions) were reviewed. Repeat CT scanning was required to all of the patients during the radiotherapy, and the number of repeat CTs varies from 2 to 6. The plan CT and repeat CT were generated by different CT scanner. To ensure the accuracy of tissue density in different CT, a modified CT density table was made to match these repeat CTs based on the plan CT. Different CT images of the same patient were registered together, and compute dose respectively on the same IMPT plan.The real dose distribution was calculated by deformable registration and weighted method in Raystation (v 4.5.1). The fraction of each dose is based on radiotherapy record. The volumetric and dose differences among these images were calculated for nascIpharyngeal tumor and retro-pharyngeal lymph nodes (GTV-NX), neck lymph nodes(GTV-ND), and parotid glands.
Results: The volume variation in GTV-NX from CT1 to CT2 was 1.15±3.79%, and in GTV-LN -0.23±4.93%. The volume variation in left parotid from CT1 to CT2 was -6.79±11.91%, and in right parotid -3.92±8.80%. In patient 2, the left parotid volume were decreased remarkably, as a result, the V30 and V40 of it were increased as well.
Conclusion: The target volume of patients with NPC varied lightly during IMRT. It shows that preradiation chemotherapy can control the target volume variation and perform a good dose repeatability. Also, the decreasing volume of parotid in some patient might increase the dose of it, which might course potential complications.

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