ABSTRACT
Objective To investigate the clinical effect of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT)and whole brain radiation therapy (WBRT) plus sequential boost conformal radiation therapy (SBCRT) in the treatment of multiple metastasis tumor of brain.Methods A total of 98 patients with multiple metastasis tumor of brain in the Radiation Oncology Center of the First Affiliated Hospital of Xinxiang Medical University from August 2014 to July 2015 were divided into observation group (n =60) and control group (n =38) according to the treatment plan.The patients in the observation group were treated with SIB-IMRT,the whole brain planned target dose was 2 Gy every time,and the target dose of the metastatic target volume was 3 Gy every time for 20 times (5 times weekly).The patients in the control group received WBRT plus SBCRT,the WBRT dose was 3 Gy every time for 10 times(5 times weekly),then the metastatic tumor target area was treated with SBCRT,the prescribed dose was 3 Gy every time for 10 times.All patients were followed up from the end of treatment to December 2016.The effective rate,disease control rate and one-year survival rate were compared between the two groups.Results The patients in the two groups were successfully treated with radiotherapy.Ninety patients were followed up,eight patients were lost to follow-up,the follow-up rate was 91.8％ (90/98).The effective rate,disease control rate and oneyear survival rate in the observation group were significantly higher than those in the control group (x2 =5.371,4.352,6.002;P ＜ 0.05).The median progression free survival time in the observation group was significantly longer than that in the control group (x2 =6.537,P ＜ 0.05).There were no significant differences in the incidence of bone marrow suppression,digestive system reaction and nervous system damage between the two groups (x2 =1.821,2.032,3.782;P ＞ 0.05).Conclusion SIB-IMRT can improve the effective rate,disease control rate and one-year survival rate of patients with multiple metastasis tumor of brain.
ABSTRACT
AIM OF STUDY: Breast conserving surgery (BCS) is the standard treatment for stage I and II breast cancer. Multiple studies have shown that recurrences after lumpectomy occur mainly in or near the tumor bed. Use of accelerated partial breast irradiation (APBI) allows for significant reduction in the overall treatment time that results in increasing patient compliance and decreasing healthcare costs. We conducted a treatment planning study to evaluate the role of intensity modulated radiation therapy (IMRT) with regards to three‑dimensional conformal radiation therapy (3DCRT) in APBI. MATERIALS AND METHODS: Computed tomography planning data sets of 33 patients (20 right sided and 13 left sided) with tumor size less than 3 cm and negative axillary lymph nodes were used for our study. Tumor location was upper outer, upper inner, central, lower inner, and lower outer quadrants in 10, 10, 5, 4 and 4 patients, respectively. Multiple 3DCRT and IMRT plans were created for each patient. Total dose of 38.5 Gy in 10 fractions were planned. Dosimetric analysis was done for the best 3DCRT and IMRT plans. RESULTS: The target coverage has been achieved by both the methods but IMRT provided better coverage (P = 0.04) with improved conformity index (P = 0.01). Maximum doses were well controlled in IMRT to below 108% (P < 0.01). Heart V2 Gy (P < 0.01), lung V5 Gy (P = 0.01), lung V10 Gy (P = 0.02), contralateral breast V1 Gy (P < 0.01), contralateral lung V2 Gy (P < 0.01), and ipsilateral uninvolved breast (P < 0.01) doses were higher with 3DCRT compared to IMRT. CONCLUSION: Dosimetrically, IMRT–APBI provided best target coverage with less dose to normal tissues compared with 3DCRT‑APBI.
ABSTRACT
Objective:To compare the dosimetry of three-dimensional conformal radiotherapy (3D-CRT), intensity modulated radiotherapy (IMRT) and simplified intensity modulated radiotherapy (sIMRT) for hepato-cellular cancer, in order to put forward the best radiation therapy plan. Methods:10 patients with hepatocellular carcinoma were designed 4 fields radiotherapy plan of 3D-CRT, IMRT and sIMRT, prescribed dose 50 Gy/20f, compared the target dose of homogeneity index (HI) and conformal index, monitor unit (MU), the dose of organ at risk (OAR) of the 3 different radiotherapy techniques. Results: Compared sIMRT respectively with 3DCRT and IMRT, target optimum conformal index IMRT was the optimal, sIMRT was the second, and 3D-CRT was the worst. The differences were statistically significant among them (t=4.95, t=4.32;P<0.05). Target homogeneity index IMRT was the optimal, sIMRT was the second, and 3D-CRT was the worst. The differences were statistically significant among them (t=3.42, t=4.02;P<0.05 statistically significant). The low dose irradiation area of normal liver, time of therapy, the child field number, the total MU and the protection of OAR:3D-CRT
ABSTRACT
Objective To analyze and compare the short-term efficacy and daverse reaction of postoperative adjuvant radio -chemotherapy versus simple chemotherapy in advanced gastric cancer .Methods A total of 64 patients with locally advanced gastric cancer were randomly but equally divided into 2 groups ,experimental group and control group .The experimental group patients ini-tially receive 4-cycles chemotherapy with Capecitabine Tablets 1 000 mg /m2 ,bid ,d1 - 14 plus Oxaliplatin 130 mg/m2 ,d1 ,and then receive Capecitabine Tablets 825 mg /m2 ,bid ,d1 - 35 plus 3DCRT 45 Gy/25 Fx /5 w concurrent radio-chemotherapy .Control group patients receive 6-cycles Capecitabine plus oxaliplatin combined chemotherapy .Then we observed the disease progression time ,toxic reaction ,1 year survival rate and 2 year survival rate simultaneously in two groups .Results The follow-up rate were 100% .The comparative results are listed as follows (experimental group and control group) :the rates of Ⅰ /Ⅱ grades of nausea and vomiting were 87 .50% and 62 .50% respectively (P 0 .05) and 84 .38% ,62 .50% respectively (P <0 .05) ;2-year overall survival rate and recurrence-free survival rate were respectively 84 .38% ,59 .38% (P< 0 .05) and 75 .00% , 50 .00% respectively (P< 0 .05) .Conclusion The advantages of 3DCRT combined with Capecitabine Tablets chemoradiotherapy can raise the successful rate of local control in patients with advanced gastric cancer after operation and 4 cycles chemotherapy .The toxic reactions are tolerable for patients .
ABSTRACT
OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.
ABSTRACT
Objective To investigate the clinical effect and safety of three dimensional conformal radiotherapy (3D-CRT)for patients with cervical cancer after radical operation in stage ⅠA to ⅡA.Methods The data of 119 patients of cervical cancer in ⅠA-ⅡA with postoperative radiotherapy in our hospital were analyzed retrospectively.Of which 56 patients were treated with 3D-CRT radiotherapy (3D-CRT group),63 patients were treated with conventional radiotherapy (conventional group).The differences radiation reactions and quality of life between two groups were compared.Results The local control rate of 3D-CRT group in the first 12 and 18 months after surgery were 87.50% and 82.14%,respectively,which were significantly higher than those of conventional group(71.43%,65.08%),the difference was statistical significance(P 0.05). Patients of 3D-CRT group were followed up for 3 years,the median survival time was 34.29 months,which was longer than the 31.08-month of conventional group,the difference was statistically significant(χ2 =4.116,P =0.042).Quality of life of 3D-CRT group (60.81 ±4.28) point was lower than that of conventional group (63.75 ±5.03)point,and the difference was statistically significant(P <0.05).The rate of early radiation reaction(rectal reaction,vaginitis)and late radiation reaction (mild or moderate radiation proctitis)in 3D-CRT group were lower than those in the conventional group,the difference was statistically significant(P <0.05 ).Conclusion The 3D-CRT has effect on the long-term prognosis of patients with cervical cancer in stage ⅠA-ⅡA,which can significantly reduce the radiation reaction and improve the quality of life of patients.
ABSTRACT
Objective To evaluate the curative effect and feasibility of three dimensional conformal radiation therapy for bony metastases,and summarize its indication.Methods Total of 53 patients with bony metastases were received radiotherapy.Results All patienrs were followed up from 3 to 12 month,6 patients discharged from hospital without any therapy,the ratio of change of pain and Clinical symptoms is 88.68％(47/53),the ratio of obviously improvement is 66.04％(35/53),the ratio of improvement is 22.64％(12/53).Conclusion The results show that Three dimensional conformal radiation therapy has obvious advantage and commendable effect on bony metastases.It is a high-performance,save and precise stereotaxis treatment facility.
ABSTRACT
Objective To investigate the influence and clinical effect of assisted three-dimensional conformal radiation therapy (3D-CRT ) on obstructive jaundice caused by malignant tumors .Methods 90 cases with obstructive jaundice caused by malignant tumors of liver ,gallbladder and pancreases were randomly divided into observation group and control group ,45 cases in each group . Patients in control group were given comprehensive measures ,including tumors exairesis ,assisted chemotherapy and stereotactic ra-diotherapy ,and patients in observation group were given 3D-CRT based on tumors exairesis and assisted chemotherapy .Clinical effect ,serum bilirubin were observed 2 months after treatment ,adverse reactions were recorded during the treatment ,and survival rate in 2-year follow up in two groups were observed .Results Total effective rate in observation group and control group were 75 .56% and 57 .78% (P<0 .05) ,respectively ,and adverse reactions rate were 37 .78% and 57 .78% (P<0 .05) ,respectively .After treatment ,serum total bilirubin and direct bilirubin in two groups were all lower than those before treatment (P<0 .05) .Serum total bilirubin and direct bilirubin in observation group after treatment were (26 .3 ± 6 .5)μmol/L and(18 .9 ± 3 .3)μmol/L ,and were (39 .3 ± 9 .5)μmol/L and(26 .9 ± 6 .7)μmol/L in control group ,and there were statistical difference between two groups (P<0 .05) . Observation group′s survival rate was higher than that of control group (P<0 .05) .Conclusion It has good clinical effect of trea-ting obstructive jaundice caused by malignant tumors by 3D-CRT ,and it prolongs the survival time ,decreases serum bilirubin and improves jaundice symptom ,so it has some guiding significance to its treatment .
ABSTRACT
Objective To compare the dosimetry of three different radiation therapy plans [threedimensional conformal radiation therapy (3DCRT),intensity modulated radiation therapy (IMRT),intensity modulated arc radiotherapy (IMAT)].Methods Selected 15 cases with middle thoracic esophageal cancer,Varian Eclipse 8.6 planning systems were designed with 3DCRT,IMRT,IMAT,3DCRT using 5-8 coplanar radiation fields,IMRT using 7 coplanar radiation fields,IMAT using 2 radians.Three planned dose difference were compared.Results Compared with 3DCRT,IMRT and IMAT were better with heterogeneity index (HI),conformality index (CI),VPTV 95 ％,V5,V20,V35 of total lung,and V30 of heart (t =2.531,P＜ 0.05).There was no statistically significant difference for the V10,V15,V25,V30 mean dose of total lung,the mean dose of heart,the maximum dose of spinal cord,and the minimum dose of PTV among the three plans (t =1.325,P ＞0.05).Conclusion IMAT and IMRT are similar in the middle thoracic esophageal cancer radiotherapy target volume dose coverage and organs at risk protection,they are better than 3DCRT.IMAT in the monitor units and delivery time are less than IMRT.
ABSTRACT
Objective To compare the efficacy for aged patients with locally advanced esophageal cancer who accepted 3D-CRT with or without S-1.Methods 62 aged patients with locally advanced esophageal cancer were randomized divided into three groups in Central Hospital of Kaifeng since March,2009.The S-1 combined with radiotherapy group was 26 patients as combined group,the single radiotherapy group was 20 patients and single drug group was 16 patients.S-1 combined group patients accepted 3D-CRT,and the patients were taken S-1 from the first day,the dose was 40 mg/m2 twice a day continually 14 days and then stop 7 days.There were 2 cycles during radiotherapy.The 20 patients accepted 3D-CRT in single radiotherapy group,and the patients in single drug group were taken S-1 only,the dose was 40 mg/m2 twice a day continually 28 days and then stop 14 days within 28 days.Results The response rate was 92.31％ in S-1 combined group,with 13 patients CR,11 patients PR,and 1 patient SD.The response rate was 60.00 ％ in single radiotherapy group,with 4 patients CR,8 patients PR and 6 patients SD.The response rate was 31.25 ％ in single drug group,with 1 patients CR,4 patients PR and 6 patients SD.The effect of the S-1 combined with radiotherapy group was significant better than the others (P ＜ 0.05).The 1,2 and 3 year survival rates in each group were 76.92 ％,57.69 ％,42.31％,75.00 ％,55.00 ％,40.00 ％ and 68.75 ％,50.00 ％,25.00 ％,which there is no significant difference in the three groups.The adverse reaction of hematologic toxicity in S-1 combined with radiotherapy group was little higher than the others,still there was no significant difference in the incidence rate of radiation esophagitis and radiation pneumonitis between S-1 combined with radiotherapy group and single radiotherapy group.Conclusion S-1 plus three dimensional conformal radiotherapy treatments were reliable,and the adverse reactions were mild and well tolerated for elderly patients with locally advanced esophageal cancer.
ABSTRACT
Objective To evaluate the dosimetric characteristics of helical tomotherapy (HT),intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiotherapy of rectal cancer.Methods Ten male patients with stage Ⅱ or Ⅲ middle or low position rectal cancer were selected retrospectively.All of the 10 patients underwent Dixon surgery and CT simulation orientation.The target volumes and normal organs were drawn in the CT images and the plans for HT,IMRT and 3D-CRT were designed.The prescribed dose was given 50 Gy in 25 fractions,covering at least 95％ of the planning target volume.Results All plans met the needs of the prescribed doses.The HT and IMRT plans met the needs of dose limit to organs at risk,however,the 3D-CRT plans failed to do that.The conformity indexes of HT,IMRT and 3D-CRT plans were 0.86,0.82 and 0.62,respectively (F =206.81,P ＜ 0.001),and the homogeneity indexes were 0.001,0.157,and 0.205,respectively (x2 =15.8,P ＜ 0.001).The 3D-CRT plans had larger volumes than the HT plans and IMRT plans in the high-dose regions such as pelvic V50,bladder V40,bowel V50 and femoral head D5 (P ＜ 0.05),but the differences between the HT plans and IMRT plans were not statistically significant (P ＞0.05).The V15 value of bowel of HT plans were higher than those of the IMRT and 3D-CRT plans (71.1％ vs.63.3％ and 67.7％,respectively).However,there was no significantly difference.Conclusions All of the HT,IMRT and 3D-CRT plans are able to meet the prescription dose requirement of the target regions of rectal cancer.The HT plans show the best dose homogeneity and target conformity,followed by the IMRT plans,and then the 3D-CRT plans.The HT plans meet the needs of all OARs slightly better than the IMRT plans.3D-CRT plans are simple and practical with poor protective ability toward the OARs.
ABSTRACT
ObjectiveTo observe the effects of traditional Chinese medicine which supplements Qi and activates blood circulation on the treatment of the X-ray radiotherapy-induced lung injury.MethodsEighty-four patients who were given three-dimensional conformal radiotherapy were randomized into treatment group and control group.The patients in treatment group were given traditional Chinese medicine, which supplements Qi and activates blood circulation, while the patients in control group were given antibiotics and hormone instead.ResultsThe outcome of treatment group was better than that of control.The response rates were 88.6％ and 60.0％, respectively (x2 = 9.16, P ＜ 0.05) .Compared with the patients in control group, the clinical manifestations and pulmonary CT reflected better response in the patients of the treatment group(x2 =12.22,P ＜ 0.05) .ConclusionThe traditional Chinese medicine, which supplements Qi and activates blood circulation,has a good therapeutical effect on radiation pneumonitis and protective role for radiation-induced pulmonary fibrosis.
ABSTRACT
Objective To investigate the dosimetric characteristics of helical tomotherapy(HT),intensity-modulated radiation therapy(IMRT)and three.dimensional conformal radiation therapy(3D-CRT)for the post-operative breast cancer as well as their comparison in protecting the normal tissues.Methods The CT images of 10 postoperative patients with early stage breast cancer were transferRed into HT and IMRT and 3D- CRT planning system respectively after the target region and normal tissues were drawn out with the same doctor.Each prescribed dose for three kinds of plans was 50 Gy/25 fractions.Inrradiation doses and volume at heart and double lungs as well as conformity index(CI)and homogeneity index(HI)were evaluated.Results The PTV volume of prescribed target dose of 95% and 100%in HT, IMRT and 3D-CRT groups were 99.13%and 95.87%,97.80%and 94.05%,96.37%and 87.29%.respectively.The CI and HI in HT.IMRT and 3D-CRT groups were 0.80±0.10 and 1.09 ±0.03,0.65±0.07 and 1.14±0.02,0.40±0.08 and 1.17±0.04,respectively V5,V10 and V20 of the heart were the lowest at 3D-CRT than HT and lM RT.V5 of the diseased lung was the lowest at 3D-CRT compared to HT and IMRT.V5 and V10 of the healthy lung were the lowest at 3 D-CRT compared to other groups.Conclusions Compared with IMRT and 3D-CRT.HT technique in treating breast cancer had the best conformity index and homogeneity index as well as steeper dose gradient.Irradiated doses and volume at the heart was the lowest at 3D- CRT and the highest at IMRT.Irradiated doses and volume of the heart and healthy lung as well as the diseased lung were the lowest at 3D-CRT compared to HT and IMRT groups.
ABSTRACT
Objective To measure the displacement of the silver clips guided by kV-plain film at state of moderate deep inspiration hold(mDIBH) assisted by active breathing control(ABC) and to explore the margin of clinical target volume(CTV) to planning target volume(PTV) for breast cancer patients treated with three-dimensional conformal external-beam partial breast irradiation (EB-PBI) assisted by ABC. Methods The patients undertook CT simulation assisted by ABC to get the CT images on the respiratory condition of mDIBH. Four selected silver clips in breast cavity were delineated and the cavity based on all of the clips were delineated as gross tumor volume (GTV). Before each irradiation, two orthogonal kV-plain films were taken for the patients in the respiratory condition of mDIBH assisted by ABC device. 2D-2D auto-matie registration was performed based on pixel between the kV-plain films and the digital reconstructed radi-ographs(DRR). Then manual registration was undertook to get the shifts of the four clips separately at LAT, LNG,and VRT directions. Based on the shift data,the margins of CTV to PTV at LAT,LNG and VRT direc-tions were calculated. Results The margins from CTV to PTV were 5.00 mm,7.78 mm and 9.30 mm at LAT,LNG and VRT directions based on the clip at cephal border of the cavity. The corresponding margins were 4.40 mm,6.43 mm and 6.73 mm based on the clip at bottom of the cavity;5.04 mm,8.63 mm and 10.54 mm based on the clip at lateral border of the cavity;5.40 mm,8.59 ram and 10.81 mm based on the clip at pedal border of the cavity. Conclusions The silver clips in breast cavity can be clearly showed on the kV-plain film. The displacement of the clips can be exactly measured by registration of kV-plain film and planning DRR in condition of mDIBH assisted by ABC. The margins from CTV to PTV for EB-PBI can be calculated based on the displacement of the clips.
ABSTRACT
Three-dimensional conformal radiation therapy(3D-CRT) and intensity-modulated radiation therapy(IMRT) are becoming important parts for research of treatment in esophageal carcinoma patients.The advances of dosimetric study in 3D-CRT,IMRT of esophageal carcinoma and the evaluation indices are reviewed.
ABSTRACT
0.05). The pulmonary function in M3 after radiotherapy were lower than that in M1 after radiotherapy of control group (P
ABSTRACT
Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.
ABSTRACT
Objective To assess and compare the advantages and disadvantages of five fields of three dimensional conformal radiation therapy(3DCRT),three fields of 3DCRT and the simulator-guided radiation therapy for patients with esophageal carcinoma.Methods Twenty patients with esophageal carcinoma were treated by three dimensional conformal radiation therapy,at the same TPS,three Dimensional conformal radiation therapy target and normal tissue of three radiotherapies were simulated.The treatment planning was five days per week with 1.8～2.0 Gy per fraction。 5 fractions per week,5OGy per 5～6 weeks. Results Compared with simulator-guided radiation therapy,3DCRT planning has better dose distribution and protection of normal tissue. Conclusion Esophageal cancer conformal radiotherapy can reduce the radiation injury of the normal tissue and complications,and improve treatment of conformal radiotherapy and the target dose distribution.
ABSTRACT
Three dimensional conformal radiation therapy is promising advance in radiation therapy that affords the potential of decreased toxicity in the management of esophageal cancer.This article reviewed the current approaches to achieving the desired dose to the esophagus and regional lymph nodes,with an emphasis on the does constraints to adjacent normal structures,particularly the heart and lungs.The delineation of target is also explored.
ABSTRACT
PURPOSE: This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. MATERIAL AND METHODS: The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. RESULTS: The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2% over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6% with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. CONCLUSION: This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning, but prospective studies are required to define the true clinical benefit.