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Table 2 Population average dose levels for s-IMRT and IMAT treatments

From: Intensity modulated arc therapy implementation in a three phase adaptive 18F-FDG-PET voxel intensity-based planning strategy for head-and-neck cancer

Target/Organ-at-risk

s-IMRT (Gy)

IMAT (Gy)

p-value

GTVT

   

 D2%

80.4 (76.4 - 83.7)

81.0 (77.2 - 85.1)

0.175

 D98%

67.3 (63.8 – 71.0)

68.4 (64.8 - 73.6)

0.009

GTVN

   

 D2%

73.3 (66.4 - 79.3)

74.8 (67.2 - 81.0)

0.014*

 D98%

64.8 (62.5 - 69.9)

66.3 (63.1 - 72.8)

0.043*

PTVHR

   

 D2%

76.9 (74.5 - 79.6)

77.9 (75.8 - 79.3)

0.013

 D98%

57.5 (54.3 - 59.4)

56.9 (52.5 - 58.7)

0.160

PTVEN

   

 D2%

66.0 (61.1 - 73.3)

67.0 (62.0 – 76.0)

0.005

 D98%

32.2 (21.2 - 42.2)

32.7 (20.2 - 40.8)

0.452

CTVHR

   

 D2%

78.1 (75.6 - 81.2)

79.1 (76.6 - 81.3)

0.023

 D98%

60.9 (59.6 - 61.6)

60.3 (58.9 - 61.5)

0.025

CTVEN

   

 D2%

66.5 (59.7 - 75.9)

67.8 (61.7 - 77.9)

0.001

 D98%

38.9 (35.2 - 44.5)

38.6 (34.1 - 42.2)

0.222

Spinal cord PRV

   

 D5%

32.4 (29.5 - 34.7)

28.4 (23 - 35.3)

0.003

 D50%

21.4 (3.5 - 28.5)

13.6 (1.8 - 21.5)

0.001

Brainstem PRV

   

 D5%

20.5 (12.4 - 28.4)

14.2 (6.1 - 23.6)

<0.001

 D50%

2.3 (1.4 - 3.1)

2.1 (1.1 - 3.4)

0.019

Ipsilateral parotid

   

 V27Gy

43.8 (34.8 - 52.5)

36.6 (24.6 - 48.1)

0.007

 Dmean

25.8 (18.7 - 31.8)

22.2 (14.9 - 29.4)

0.001

Contralateral parotid

   

 V27Gy

40.0 (27.6 - 50.1)

33.0 (13.2 - 47.4)

0.003

 Dmean

24.4 (16.9 - 30.6)

21.3 (12.5 - 27.5)

<0.001

PC

   

 D2%

67.3 (63.9 - 73.3)

67.6 (63.5 – 74.0)

0.469

 D50%

57.0 (49.1 – 62.0)

53.4 (38.2 - 60.8)

0.021

 D98%

36.3 (19.4 - 51.3)

25.1 (11.1 - 43.7)

<0.001

SS

   

 D2%

68.0 (61.0 - 77.6)

68.0 (60.8 - 76.6)

0.903

 D50%

53.5 (40.5 - 63.8)

47.4 (32.5 - 63.2)

0.003

 D98%

34.3 (24.1 - 40.3)

23.3 (12.4 - 31.2)

<0.001

Mandible

   

 D2%

53.6 (34.4 - 68.1)

53.6 (35.0 - 66.9)

0.923

  1. The dose distributions of the 3 treatment phases were summed on the pretreatment CT. Reporting is done on manually delineated targets and organs-at-risk. Statistically significant differences are shown in bold
  2. Abbreviations: s-IMRT step-and-shoot IMRT, IMAT intensity modulated arc therapy, GTV T gross tumor volume of the primary tumor, GTV N GTV of the metastatic lymph nodes, CTV HR high-risk clinical target volume, PTV HR high-risk planning target volume, CTV EN elective neck CTV, PTV EN elective neck PTV, PRV planning organ-at-risk volume, SS swallowing structures include the superior, middle and inferior pharyngeal constrictor muscles, upper esophageal sphincter, supraglottic larynx and upper 2 cm of the cervical esophagus, PC pharyngeal constrictors include the superior, middle and inferior pharyngeal constrictor muscles, D x% dose received by x% of the volume, V 27Gy % of the volume that receives at least 27 Gy
  3. *Of 10 patients, 6 had metastatic lymph nodes