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Dosimetric comparison of postoperative interstitial high-dose-rate brachytherapy and modern external beam radiotherapy modalities in tongue and floor of the mouth tumours in terms of doses to critical organs

Örs Ferenczi
Örs Ferenczi
, 
Tibor Major
Tibor Major
, 
Georgina Fröhlich
Georgina Fröhlich
, 
Dalma Béla
Dalma Béla
, 
Szabolcs Tódor
Szabolcs Tódor
, 
Csaba Polgár
Csaba Polgár
, 
Hironori Akiyama
Hironori Akiyama
, 
Botond Bukovszky
Botond Bukovszky
 et 
Zoltán Takácsi-Nagy
Zoltán Takácsi-Nagy
   | 30 nov. 2023
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Article Category: Research Article
Publié en ligne: 30 nov. 2023
Pages: 516 - 523
Reçu: 19 mai 2023
Accepté: 23 août 2023
DOI: https://doi.org/10.2478/raon-2023-0050
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© 2023 Örs Ferenczi et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Representative dose distributions in a brachytherapy (BT), a volumetric modulated arc therapy (VMAT) and a Cyberknife (CK) plan.
Representative dose distributions in a brachytherapy (BT), a volumetric modulated arc therapy (VMAT) and a Cyberknife (CK) plan.

FIGURE 2.

Mean dose in % to the most exposed 2 cm3 volume of the mandible.BT = brachytherapy; CK = Cyberknife; VMAT = volumetric modulated arc therapy
Mean dose in % to the most exposed 2 cm3 volume of the mandible.BT = brachytherapy; CK = Cyberknife; VMAT = volumetric modulated arc therapy

FIGURE 3.

Mean dose to the most exposed 2 cm3 volume of the ipsilateral parotid.BT = brachytherapy; CK = Cyberknife; VMAT = volumetric modulated arc therapy
Mean dose to the most exposed 2 cm3 volume of the ipsilateral parotid.BT = brachytherapy; CK = Cyberknife; VMAT = volumetric modulated arc therapy

Mean dosimetric parameters of organs at risk (OARs) with ranges

BT VMAT CK p-value* BT vs. VMAT** BT vs. CK** VMAT vs. CK**
Mandible D2 (%) 47.4 (29.2–73.4) 92.2 (73.1–100.4) 68.4 (39.3–87.3) < 0.001 < 0.001 < 0.001 < 0.001
D0.1 (%) 73.9 (1.7–93.9) 101.8 (97.1–103.9) 92.3 (72.7–100.7) < 0.001 < 0.001 < 0.001 NS
Ipsilateral parotid gland D2 (%) 4.8 (2.5–11.9) 7.3 (0.9–13.9) 2.3 (0.3–6.7) < 0.001 0.0011 NS < 0.001
D0.1 (%) 6.7 (3.5–19.0) 13.8 (3.7–25.0) 5.1 (0.3–12.3) < 0.001 < 0.001 NS < 0.001
Contralateral parotid gland D2 (%) 3. (0.0–7.6) 6.8 (0.6–15.8) 1.5 (0.0–4.7) < 0.001 0.0018 NS < 0.001
D0.1 (%) 4.9 (0.0–11.9) 10.9 (0.9–20.2) 3.3 (0.3–14.0) < 0.001 0.0105 NS 0.0020
Contralateral submandibular gland D2 (%) 7.3 (3.9–16.3) 9.0 (0.8–17.7) 3.6 (2.0–6.0) 0.0098 NS 0.0198 0.0016
D0.1 (%) 9.4 (6.2–21.4) 14.3 (2.1–23.1) 5.6 (3.0–11.3) 0.0098 NS 0.0146 < 0.001

Mean dosimetric parameters of planning target volume (PTV) with ranges

BT VMAT CK p-value* BT vs. VMAT** BT vs. CK** VMAT vs. CK**
VPTV (cm3) 12.5 (2.6–21.5) 26.5 (7.7–42.6) 17.5 (5.6–33.6) < 0.001 < 0.001 0.5553 0.0043
Conformal index 0.62 (0.48–0.80) 0.84 (0.78–0.87) 0.86 (0.79–0.93) < 0.001 < 0.001 < 0.001 0.5480
Homogenity index DNR = 0.38 (0.30–0.50) 0.09 (0.05 – 0.10) 0.20 (0.17–0.20) NA NA NA < 0.001
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