ABSTRACT
Objective To analyze and compare the outcomes of esophageal carcinoma treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and late course boost intensity-modulated radiation therapy (LCB-IMRT).Methods We retrospectively analyzed 128 patients with esophageal squamous cell carcinoma who were treated with SIB-IMRT or LCB-IMRT at the fifth department of radiation oncology in our hospital,from January 2009 to August 2015.Propensity score matching analysis was used to balance the variables differences in the two groups.Survival,failure patterns and toxicities were observed and compared between the two groups.Results one hundred and eleven patients were finally included after propensity scores matching.The 1-,3-and 5-year local control rates and survival rates were 83.6％ vs.81.7％,70.8％ vs.46.3％ and 66.0％ vs.38.2％ in the whole group,respectively.The 1-,3-and 5-year local control rates of SIB-IMRT and LCB-IMRT group were 81.6％ vs.88.0％,72.3％ vs.67.6％ and68.5％ vs.60.8％,respectively (P＞0.05).The 1-,3-and 5-year survival rates of SIB-IMRT and LCB-IMRT group were 81.3％ vs.82.4％,51.7％ vs.36.7％ and 45.8％ vs.26.7％,respectively (P ＞ 0.05).There was no statistical difference between the two group in ≥ grade 3 toxicities (P ＞ 0.05).There were 40 (36.0％) patients result in treatment failure in all.The treatment failure rates in SIB-IMRT and LCB-IMRT group were 33.8％ (26/77) vs.41.2％ (14/34),respectively (P ＞ 0.05).The local failure accounted for 65.0％ (26/40) of all treatment-related failures.Conclusions The toxicities of esophageal squamous cell carcinoma treated with SIB-IMRT and LCB-IMRT have no significant differences and were well tolerated.There were no significant differences in local control rates and survival rates between the two groups.However,SIB-IMRT had better trend than LCB-IMRT.Given SIB-IMRT's convenient manipulation,it could be a better choice in the treatment of advanced esophageal carcinoma.
ABSTRACT
Objective To investigate the feasibility of sequential intensity-modulated radiotherapy (sIMRT)and simultaneously integrated boost intensity-modulated radiotherapy(SIB-IMRT)in the radiotherapy of brain metastasis,the dosimetric difference of target volumes and organs at risk(OARs). Methods Twenty pa-tients diagnosed as brain metastasis were randomly selected,with SIB-IMRT and sIMRT programs developed for each patient. Dosimetric differences between target areas and OARs were compared between the two radiotherapy protocols. Results Compared with sIMRT,SIB-IMRT had no significant difference in the average irradiation dose of the brainstem[(42.69 ± 2.18)Gy vs.(41.98 ± 0.96)Gy]and homogeneity index(HI)(1.46 ± 0.04 vs.1.42 ± 0.13)of P-CTV(P > 0.05). However,SIB-IMRT plan achieved higher than sIMRT in the conformation index (CI)(0.68 ± 0.05 vs. 0.44 ± 0.04)and HI(1.03 ± 0.01 vs. 1.06 ± 0.01)of P-GTV. Meanwhile,both maximum exposure dose of OARs and CI of P-CTV(0.68 ± 0.05 vs.0.44 ± 0.04)of SIB-IMRT were significant in comparison with sIMRT(P<0.05).Conclusions Both radiotherapies can meet target coverage and dose requirements.Com-pared to sIMRT technique,SIB-IMRT technique can decrease effectively the exposure dose of surrounding organs, and can give the tumor target more uniform physical dose conformation.