Material and methods: Dose plans for the first thirty patients enroled were analysed. Standard and escalated plans were created for all patients, blinded to randomization, and compared for each patient in terms of the ability to escalate while protecting normal tissue.
Results: The median dose-escalation in FDG-avid areas was 93.9 Gy (tumour) and 73.0 Gy (lymph nodes). Escalation drove the GTV and CTV to mean doses for the tumour of 87.5 Gy (GTV-T) and 81.3 Gy (CTV-T) in median. No significant differences in mean dose to lung and heart between standard and escalated were found, but small volumes of e.g. the bronchi received doses between 66 and 74 Gy due to escalation.
Conclusions: FDG-driven inhomogeneous dose-escalation achieves large increment in tumour and lymph node dose, while delivering similar doses to normal tissue as homogenous standard plans.
- Randomized phase-III trial