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J Med Oncl Ther 2017 | Volume 2 Issue 4
Oncology and Biomarkers Summit
November 27-28, 2017 | Atlanta, USA
Annual Congress on
Adaptive radiotherapy and its clinical application: An institutional experience
Suman Das
Queens NRI Hospital, India
Introduction:
Radiotherapy is an integral part of cancer
treatment and with the advent of newer technologies it
has undergone a paradigm shift. The adaptive radiotherapy
or more appropriately adaptive re-planning refers to any
strategy that repeats the treatment planning process during
treatment in response to anatomic changes in the target
volume or the nearby critical structures.
Materials & Methods:
Patients with proven evidence of
malignancy were considered for radiotherapy with curative
intent. The patients were simulated and planned with IMRT
radiotherapy technique. After necessary quality assurance
exercise they were approved for treatment. All patients
were subjected to daily image guidance using CBCT and
KV X-ray. During the process, if any patient was observed
to have significant variation in planning target volume due
to anatomical change, were re-planned. The cases where
the use of adaptive radiotherapy has resulted in significant
clinical outcome were isolated for presentation.
Results:
The adaptive radiotherapy was most commonly
used for Head and Neck cancer due to anatomical changes
for weight loss or change in the size of the node. These
patients were significantly benefited in terms of saving the
normal structures being radiated due to the anatomical
change. We observed few special cases like Adenoid Cystic
Carcinoma (ACC) of bronchus with collapsed lung where the
collapsed lung was inflated during treatment and resulted in
shifting of GTV medially and the adjacent critical structures.
The patient was re-planned and was delivered curative dose
of radiotherapy. It was observed that if such patients are not
timely intervened the dose delivery to tumor would not be
appropriate and the critical structures would get more dose
of radiation. These patients were followed up and good
clinical outcome was observed. The patient with ACC of
bronchus had a disease-free interval of 38 months and she is
surviving while writing this paper after 48 months with good
quality of life.
Conclusion:
The Adaptive re-planning or Adaptive
Radiotherapy is a boon to the advancement of radiotherapy.
This helps us to achieve better dose delivery to tumors and
protection of adjacent normal structures. Though it has
proven advantages in head and neck cancer, but it could
also be very much useful in certain unusual cases like
adenoid cystic carcinoma of bronchus. As per the literature,
patients with ACC of bronchus treated with radiotherapy
had a median survival of 23 months, where as our patient is
surviving after 48 months while writing this paper.
Speaker Biography
Suman Das is a consultant Radiation Oncologist in Queens NRI Hospital Visakhapatnam
India. He was granted UICC fellowship at University of Michigan Ann Arbor USA. He has
got many publications in various peer reviewed journals of Oncology. He has special
interest in Head and Neck cancers.
e:
drsumandas@gmail.com