Optimal Radiation Port Arrangements for Hepatic Tumor using 3-dimensional Conformal Radiotherapy Planning

The purpose of this study was to investigate the optimal beam arrangements for hepatic tumors, according to the location of the hepatic tumor and its relationship to organs at risk (OARs). The virtual gross tumor volumes were divided into four groups according to the Couinaud's classification. Several plans were made for each virtual target, and these plans were compared for the normal tissue complication probabilities (NTCP). For group I, NTCP improved as the number of the beam ports increased. However, plans with more than 5 ports had little advantage. For group II, plans with the beam directions from the anterior side showed better results. Group III contained many OARs near the target, which placed restrictions on the beam-directions. Multi-directional plans yielded a higher dose to the OARs than a simple two-port plan using right anterior oblique and posterior beam (RAO/PA). For group IV, a simple RAO/PA port plan was adequate for protection of remaining liver. NTCP can significantly vary between radiotherapy plans when the location of the tumor and its neighboring OARs are taken into consideration. The results in this study of optimal beam arrangements could be a useful set of guidelines for radiotherapy of hepatic tumors.ope