TY - JOUR
T1 - Ovary-Sparing Radiation Planning Techniques Can Achieve Ovarian Dose Reduction for Soft Tissue Sarcoma of the Buttock and Thigh
AU - Kovtun, Konstantin A.
AU - Yeo, Wee Pin
AU - Phillips, Catherine H.
AU - Viswanathan, Akila
AU - Baldini, Elizabeth H.
N1 - Publisher Copyright:
© 2017 Konstantin A. Kovtun et al.
PY - 2017
Y1 - 2017
N2 - Background and Objectives. Attention to ovary dose is important for premenopausal women undergoing radiation therapy (RT) and must not be overlooked when treating extremity sarcoma. We assessed whether ovary-sparing RT plans could decrease ovary dose without compromising target coverage. Methods. Standard sarcoma target volumes and organs at risk (OAR) were contoured by a sarcoma dedicated radiation oncologist on CT planning scans for 23 women with thigh or buttock sarcoma. IMRT plans (50 Gy) with and without attempted ovary-sparing were created by an expert sarcoma dosimetrist. Results. All plans met target coverage goals. Compared to standard plans, ovary-sparing plans had lower mean bilateral ovary doses (MBOD) (652 versus 483 cGy, p=0.007) but higher bone doses (mean V50: 8.5% versus 6.9%, p=0.049) and lower conformity indexes (1.12 versus 1.19, p=0.009). Tumors < 8 cm from the pubic symphysis had significant MBOD reduction with ovary-sparing plans (376 cGy versus 619 cGy, p=0.0184). On multivariate analysis, distance to pubic symphysis and proximal medial thigh site were associated with MBOD reduction with ovary-sparing plan. Conclusions. For preoperative IMRT, ovary-sparing planning significantly reduces ovarian dose in women with sarcoma of the proximal thigh and near the pubic symphysis.
AB - Background and Objectives. Attention to ovary dose is important for premenopausal women undergoing radiation therapy (RT) and must not be overlooked when treating extremity sarcoma. We assessed whether ovary-sparing RT plans could decrease ovary dose without compromising target coverage. Methods. Standard sarcoma target volumes and organs at risk (OAR) were contoured by a sarcoma dedicated radiation oncologist on CT planning scans for 23 women with thigh or buttock sarcoma. IMRT plans (50 Gy) with and without attempted ovary-sparing were created by an expert sarcoma dosimetrist. Results. All plans met target coverage goals. Compared to standard plans, ovary-sparing plans had lower mean bilateral ovary doses (MBOD) (652 versus 483 cGy, p=0.007) but higher bone doses (mean V50: 8.5% versus 6.9%, p=0.049) and lower conformity indexes (1.12 versus 1.19, p=0.009). Tumors < 8 cm from the pubic symphysis had significant MBOD reduction with ovary-sparing plans (376 cGy versus 619 cGy, p=0.0184). On multivariate analysis, distance to pubic symphysis and proximal medial thigh site were associated with MBOD reduction with ovary-sparing plan. Conclusions. For preoperative IMRT, ovary-sparing planning significantly reduces ovarian dose in women with sarcoma of the proximal thigh and near the pubic symphysis.
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U2 - 10.1155/2017/2796925
DO - 10.1155/2017/2796925
M3 - Article
C2 - 29311758
AN - SCOPUS:85030769321
SN - 1357-714X
VL - 2017
JO - Sarcoma
JF - Sarcoma
M1 - 2796925
ER -