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Dosimetric comparison of intensity modulated radiotherapy and three-dimensional conformal radiotherapy in patients with gynecologic malignancies: a systematic review and meta-analysis.

Yang B, Zhu L, Cheng H, Li Q, Zhang Y, Zhao Y - Radiat Oncol (2012)

Bottom Line: Reduction in irradiated small bowel was also observed for IMRT-delivered 40 Gy and 45 Gy (by 17.80% (p = 0.043) and 17.30% (p = 0.012), respectively), as compared with 3D-CRT.IMRT-treated patients did not experience more severe acute or chronic toxicities than 3D-CRT-treated patients.IMRT-delivered high radiation dose produced significantly less average percent volumes of irradiated rectum and small bowel than 3D-CRT, but did not differentially affect the average percent volumes in the bladder and bone marrow.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gynecologic Oncology, Cancer Hospital of Harbin Medical University, 150 Haping Street, Nangang District, Harbin, Heilongjiang Province, PR China.

ABSTRACT

Background: To quantitatively evaluate the safety and related-toxicities of intensity modulated radiotherapy (IMRT) dose-volume histograms (DVHs), as compared to the conventional three-dimensional conformal radiotherapy (3D-CRT), in gynecologic malignancy patients by systematic review of the related publications and meta-analysis.

Methods: Relevant articles were retrieved from the PubMed, Embase, and Cochrane Library databases up to August 2011. Two independent reviewers assessed the included studies and extracted data. Pooled average percent irradiated volumes of adjacent non-cancerous tissues were calculated and compared between IMRT and 3D-CRT for a range of common radiation doses (5-45 Gy).

Results: In total, 13 articles comprised of 222 IMRT-treated and 233 3D-CRT-treated patients were included. For rectum receiving doses ≥30 Gy, the IMRT pooled average irradiated volumes were less than those from 3D-CRT by 26.40% (30 Gy, p = 0.004), 27.00% (35 Gy, p = 0.040), 37.30% (40 Gy, p = 0.006), and 39.50% (45 Gy, p = 0.002). Reduction in irradiated small bowel was also observed for IMRT-delivered 40 Gy and 45 Gy (by 17.80% (p = 0.043) and 17.30% (p = 0.012), respectively), as compared with 3D-CRT. However, there were no significant differences in the IMRT and 3D-CRT pooled average percent volumes of irradiated small bowel or rectum from lower doses, or in the bladder or bone marrow from any of the doses. IMRT-treated patients did not experience more severe acute or chronic toxicities than 3D-CRT-treated patients.

Conclusions: IMRT-delivered high radiation dose produced significantly less average percent volumes of irradiated rectum and small bowel than 3D-CRT, but did not differentially affect the average percent volumes in the bladder and bone marrow.

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Related in: MedlinePlus

Flow chart of identification and selection of papers for study.
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Figure 1: Flow chart of identification and selection of papers for study.

Mentions: A study was selected for inclusion if it provided information on DVHs of different irradiated organs that had been treated with IMRT or 3D-CRT. Those studies were then selected for the following criteria: 1) prescription dose of Gy or 50.4 Gy, for either IMRT or 3D-CRT, with all patients having received radiation doses of 1.8 Gy/day; 2) irradiated normal organs at risk being small bowel, bladder, rectum, and bone marrow; 3) data from the DVHs in irradiated organs at risk being relative number and not the actual measured value; and 4) studies being independent and not replicates of a single population. If studies were found to overlap, the largest dataset was selected for inclusion. A flowchart of the strategy used for this systematic review of the literature is presented in Figure 1.


Dosimetric comparison of intensity modulated radiotherapy and three-dimensional conformal radiotherapy in patients with gynecologic malignancies: a systematic review and meta-analysis.

Yang B, Zhu L, Cheng H, Li Q, Zhang Y, Zhao Y - Radiat Oncol (2012)

Flow chart of identification and selection of papers for study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539899&req=5

Figure 1: Flow chart of identification and selection of papers for study.
Mentions: A study was selected for inclusion if it provided information on DVHs of different irradiated organs that had been treated with IMRT or 3D-CRT. Those studies were then selected for the following criteria: 1) prescription dose of Gy or 50.4 Gy, for either IMRT or 3D-CRT, with all patients having received radiation doses of 1.8 Gy/day; 2) irradiated normal organs at risk being small bowel, bladder, rectum, and bone marrow; 3) data from the DVHs in irradiated organs at risk being relative number and not the actual measured value; and 4) studies being independent and not replicates of a single population. If studies were found to overlap, the largest dataset was selected for inclusion. A flowchart of the strategy used for this systematic review of the literature is presented in Figure 1.

Bottom Line: Reduction in irradiated small bowel was also observed for IMRT-delivered 40 Gy and 45 Gy (by 17.80% (p = 0.043) and 17.30% (p = 0.012), respectively), as compared with 3D-CRT.IMRT-treated patients did not experience more severe acute or chronic toxicities than 3D-CRT-treated patients.IMRT-delivered high radiation dose produced significantly less average percent volumes of irradiated rectum and small bowel than 3D-CRT, but did not differentially affect the average percent volumes in the bladder and bone marrow.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gynecologic Oncology, Cancer Hospital of Harbin Medical University, 150 Haping Street, Nangang District, Harbin, Heilongjiang Province, PR China.

ABSTRACT

Background: To quantitatively evaluate the safety and related-toxicities of intensity modulated radiotherapy (IMRT) dose-volume histograms (DVHs), as compared to the conventional three-dimensional conformal radiotherapy (3D-CRT), in gynecologic malignancy patients by systematic review of the related publications and meta-analysis.

Methods: Relevant articles were retrieved from the PubMed, Embase, and Cochrane Library databases up to August 2011. Two independent reviewers assessed the included studies and extracted data. Pooled average percent irradiated volumes of adjacent non-cancerous tissues were calculated and compared between IMRT and 3D-CRT for a range of common radiation doses (5-45 Gy).

Results: In total, 13 articles comprised of 222 IMRT-treated and 233 3D-CRT-treated patients were included. For rectum receiving doses ≥30 Gy, the IMRT pooled average irradiated volumes were less than those from 3D-CRT by 26.40% (30 Gy, p = 0.004), 27.00% (35 Gy, p = 0.040), 37.30% (40 Gy, p = 0.006), and 39.50% (45 Gy, p = 0.002). Reduction in irradiated small bowel was also observed for IMRT-delivered 40 Gy and 45 Gy (by 17.80% (p = 0.043) and 17.30% (p = 0.012), respectively), as compared with 3D-CRT. However, there were no significant differences in the IMRT and 3D-CRT pooled average percent volumes of irradiated small bowel or rectum from lower doses, or in the bladder or bone marrow from any of the doses. IMRT-treated patients did not experience more severe acute or chronic toxicities than 3D-CRT-treated patients.

Conclusions: IMRT-delivered high radiation dose produced significantly less average percent volumes of irradiated rectum and small bowel than 3D-CRT, but did not differentially affect the average percent volumes in the bladder and bone marrow.

Show MeSH
Related in: MedlinePlus