Dosimetric and Clinical Influence of 3D Versus 2D Planning in Postoperative Radiation Therapy for Gastric Cancer
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Purpose The purpose of this study is to investigate the dosimetric and clinical influence of computedtomography–based (3-dimensional [3D]) simulation versus conventional 2-dimensional(2D)–based simulation in postoperative chemoradiotherapy (CRT) for patients withadvanced gastric cancer in terms of parallel opposed anteroposterior-posteroanterior fieldarrangement. Materials and MethodsA retrospective stage-matched cohort study was conducted in 158 patients treated withadjuvant CRT following curative surgery and D2 dissection from 2006 to 2008 at SamsungMedical Center: 98 patients in the 3D group; and 60 patients in the 2D group. For comparisonof the dosimetric parameters between 3D plan and 2D plan, second sets of radiationtreatment plans were generated according to the same target delineation method used inthe 2D group for each patient in the 3D group (V2D). Acute toxicity, recurrence, and survivalwere analyzed. The median follow-up period was 28 months (range, 5 to 51 months). ResultsThe 3D group showed better dose-volume histogram (DVH) profiles than the V2D group forall dosimetric parameters, including the kidneys, liver, spinal cord, duodenum, pancreas,and bowel. However, no difference in acute gastrointestinal toxicity and survival outcomeswas observed between the 3D group and the 2D group. ConclusionThe 3D plan enabled precise delineation of the target volume and organs at risk by visualizationof geometric changes in the internal organs after surgery. The DVH of normal tissuesin the 3D plan was superior to that of the V2D plan, but similar clinical features wereobserved between the 3D group and the 2D group.
Abstract
Purpose The purpose of this study is to investigate the dosimetric and clinical influence of computedtomography–based (3-dimensional [3D]) simulation versus conventional 2-dimensional(2D)–based simulation in postoperative chemoradiotherapy (CRT) for patients withadvanced gastric cancer in terms of parallel opposed anteroposterior-posteroanterior fieldarrangement. Materials and MethodsA retrospective stage-matched cohort study was conducted in 158 patients treated withadjuvant CRT following curative surgery and D2 dissection from 2006 to 2008 at SamsungMedical Center: 98 patients in the 3D group; and 60 patients in the 2D group. For comparisonof the dosimetric parameters between 3D plan and 2D plan, second sets of radiationtreatment plans were generated according to the same target delineation method used inthe 2D group for each patient in the 3D group (V2D). Acute toxicity, recurrence, and survivalwere analyzed. The median follow-up period was 28 months (range, 5 to 51 months). ResultsThe 3D group showed better dose-volume histogram (DVH) profiles than the V2D group forall dosimetric parameters, including the kidneys, liver, spinal cord, duodenum, pancreas,and bowel. However, no difference in acute gastrointestinal toxicity and survival outcomeswas observed between the 3D group and the 2D group. ConclusionThe 3D plan enabled precise delineation of the target volume and organs at risk by visualizationof geometric changes in the internal organs after surgery. The DVH of normal tissuesin the 3D plan was superior to that of the V2D plan, but similar clinical features wereobserved between the 3D group and the 2D group.
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