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    Keywords: radiotherapy ; Germany ; LUNG ; imaging ; LUNG-CANCER ; RISK ; TISSUE ; NUCLEAR-MEDICINE ; radiation ; PATIENT ; INDEX ; TARGET ; chemotherapy ; NORMAL TISSUE ; nuclear medicine ; mesothelioma ; PLEURAL MESOTHELIOMA ; IMRT ; FEASIBILITY ; MANAGEMENT ; NECK-CANCER ; radiology ; ONCOLOGY ; methods ; NUCLEAR ; MODULATED RADIATION-THERAPY ; MEDICINE ; comparison ; PENCIL BEAM ; TOMOTHERAPY ; TREATMENT PLANS ; MPM ; helical tomotherapy ; EXTRAPLEURAL PNEUMONECTOMY ; HEIDELBERG EXPERIENCE ; HEMITHORACIC RADIATION ; step-and-shoot IMRT
    Abstract: Purpose: To evaluate the potential of helical tomotherapy in the adjuvant treatment of malignant pleural mesothelionna and compare target homogeneity, conformity and normal tissue dose with step-and-shoot intensity-modulated radiotherapy. Methods and materials: Ten patients with malignant pleural mesothelioma who had undergone neoadjuvant chemotherapy with cisplatin and permetrexed followed by extrapleural pneumonectomy (EPP) were treated in our department with 54 Gy to the hemithorax delivered by step-and-shoot IMRT. A planning comparison was performed by creating radiation plans for helical tomotherapy. The different plans were compared by analysing target homogeneity using the homogeneity indices HImax and HImin and target conformity by using the conformity index CI95. To assess target coverage and normal tissue sparing TV90, TV95 and mean and maximum doses were compared. Results: Both modalities achieved excellent dose distributions while sparing organs at risk. Target coverage and homogeneity could be increased significantly with helical tomotherapy compared with step-and-shoot IMRT. Mean dose to the contralateral lung could be lowered beyond 5 Gy. Conclusions: Our planning study showed that helical tomotherapy is an excellent option for the adjuvant intensity-modulated radiotherapy of MPM. It is capable of improving target coverage and homogeneity. (c) 2007 Elsevier Ireland Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 18207597
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