{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:46:51Z","timestamp":1773773211948,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Purpose<\/jats:title>\n            <jats:p>To investigate combining <jats:italic>unmodulated<\/jats:italic> electron beams with intensity-modulated radiation therapy to improve dose distributions for superficial head and neck cancers, and to compare mixed beam plans with helical tomotherapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Mixed beam and helical tomotherapy dose plans were developed for two patients with parotid gland tumors and two patients with nasal cavity tumors. Mixed beam plans consisted of various weightings of a enface electron beam and IMRT, which was optimized after calculation of the electron dose to compensate for heterogeneity in the electron dose distribution within the target volume.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Helical tomotherapy plans showed dose conformity and homogeneity in the target volume that was equal to or better than the mixed beam plans. Electron-only plans tended to show the lowest doses to normal tissues, but with markedly worse dose conformity and homogeneity than in the other plans. However, adding a 20% IMRT dose fraction (<jats:italic>i.e<\/jats:italic>., IMRT:electron weighting = 1:4) to the electron plan restored target conformity and homogeneity to values comparable to helical tomotherapy plans, while maintaining lower normal tissue dose.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Mixed beam treatments offer some dosimetric advantages over IMRT or helical tomotherapy for target depths that do not exceed the useful range of the electron beam. Adding a small IMRT component (<jats:italic>e.g<\/jats:italic>., IMRT:electron weighting = 1:4) to electron beam plans markedly improved target dose homogeneity and conformity for the cases examined in this study.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1748-717x-6-178","type":"journal-article","created":{"date-parts":[[2011,12,28]],"date-time":"2011-12-28T19:45:53Z","timestamp":1325101553000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Preliminary comp arison of helical tomotherapy and mixed beams of unmodulated electrons and intensity modulated radiation therapy for treating superficial cancers of the parotid gland and nasal cavity"],"prefix":"10.1186","volume":"6","author":[{"given":"Olivier","family":"Blasi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas D","family":"Fontenot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert S","family":"Fields","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P","family":"Gibbons","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth R","family":"Hogstrom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2011,12,28]]},"reference":[{"key":"502_CR1","volume-title":"Clinical applications of the electron beam","author":"ND Tapley","year":"1976","unstructured":"Tapley ND: Clinical applications of the electron beam. 1976, New York, NY, USA: John Wiley & Sons Inc."},{"key":"502_CR2","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/j.ijrobp.2003.09.059","volume":"58","author":"L Cozzi","year":"2004","unstructured":"Cozzi L, Fogliata A, Bolsi A, et al: Three-dimensional conformal vs. intensity-modulated radiotherapy in head-and-neck cancer patients: comparative analysis of dosimetric and technical parameters. Int J Radiat Oncol Biol Phys. 2004, 58: 617-24. 10.1016\/j.ijrobp.2003.09.059.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"502_CR3","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/S1053-4296(99)80058-7","volume":"9","author":"TR Mackie","year":"1999","unstructured":"Mackie TR, Balog J, Ruchala K, et al: Tomotherapy. Semin Radiat Oncol. 1999, 9: 108-17. 10.1016\/S1053-4296(99)80058-7.","journal-title":"Semin Radiat Oncol"},{"key":"502_CR4","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1016\/j.radonc.2006.02.009","volume":"78","author":"C Fiorino","year":"2006","unstructured":"Fiorino C, Dell'Oca I, Pierelli A, et al: Significant improvement in normal tissue sparing and target coverage for head and neck cancer by means of helical tomotherapy. Radiother Oncol. 2006, 78: 276-82. 10.1016\/j.radonc.2006.02.009.","journal-title":"Radiother Oncol"},{"key":"502_CR5","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1016\/j.ijrobp.2007.10.024","volume":"70","author":"TK Lee","year":"2008","unstructured":"Lee TK, Rosen II, Gibbons JP, et al: Helical tomotherapy for parotid gland tumors. Int J Radiat Oncol Biol Phys. 2008, 70: 883-91. 10.1016\/j.ijrobp.2007.10.024.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"502_CR6","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1088\/0031-9155\/54\/2\/010","volume":"54","author":"EE Klein","year":"2009","unstructured":"Klein EE, Mamalui-Hunter M, Low DA: Delivery of modulated electron beams with conventional photon multi-leaf collimators. Phys Med Biol. 2009, 54: 327-39. 10.1088\/0031-9155\/54\/2\/010.","journal-title":"Phys Med Biol"},{"key":"502_CR7","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1088\/0031-9155\/53\/5\/003","volume":"53","author":"EE Klein","year":"2008","unstructured":"Klein EE, Vicic M, Ma CM, et al: Validation of calculations for electrons modulated with conventional photon multileaf collimators. Phys Med Biol. 2008, 53: 1183-208. 10.1088\/0031-9155\/53\/5\/003.","journal-title":"Phys Med Biol"},{"key":"502_CR8","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1088\/0031-9155\/55\/5\/010","volume":"55","author":"FJ Salguero","year":"2010","unstructured":"Salguero FJ, Arrans R, Palma BA, et al: Intensity- and energy-modulated electron radiotherapy by means of an xMLC for head and neck shallow tumors. Phys Med Biol. 2010, 55: 1413-27. 10.1088\/0031-9155\/55\/5\/010.","journal-title":"Phys Med Biol"},{"key":"502_CR9","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/j.radonc.2009.08.021","volume":"93","author":"FJ Salguero","year":"2009","unstructured":"Salguero FJ, Palma B, Arrans R, et al: Modulated electron radiotherapy treatment planning using a photon multileaf collimator for post-mastectomized chest walls. Radiother Oncol. 2009, 93: 625-32. 10.1016\/j.radonc.2009.08.021.","journal-title":"Radiother Oncol"},{"key":"502_CR10","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1118\/1.1644516","volume":"31","author":"KR Hogstrom","year":"2004","unstructured":"Hogstrom KR, Boyd RA, Antolak JA, et al: Dosimetry of a prototype retractable eMLC for fixed-beam electron therapy. Med Phys. 2004, 31: 443-62. 10.1118\/1.1644516.","journal-title":"Med Phys"},{"key":"502_CR11","doi-asserted-by":"publisher","first-page":"2708","DOI":"10.1118\/1.1328082","volume":"27","author":"MC Lee","year":"2000","unstructured":"Lee MC, Jiang SB, Ma CM: Monte Carlo and experimental investigations of multileaf collimated electron beams for modulated electron radiation therapy. Med Phys. 2000, 27: 2708-18. 10.1118\/1.1328082.","journal-title":"Med Phys"},{"key":"502_CR12","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.1088\/0031-9155\/45\/8\/316","volume":"45","author":"CM Ma","year":"2000","unstructured":"Ma CM, Pawlicki T, Lee MC, et al: Energy- and intensity-modulated electron beams for radiotherapy. Phys Med Biol. 2000, 45: 2293-311. 10.1088\/0031-9155\/45\/8\/316.","journal-title":"Phys Med Biol"},{"key":"502_CR13","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1088\/0031-9155\/48\/7\/308","volume":"48","author":"CM Ma","year":"2003","unstructured":"Ma CM, Ding M, Li JS, et al: A comparative dosimetric study on tangential photon beams, intensity-modulated radiation therapy (IMRT) and modulated electron radiotherapy (MERT) for breast cancer treatment. Phys Med Biol. 2003, 48: 909-24. 10.1088\/0031-9155\/48\/7\/308.","journal-title":"Phys Med Biol"},{"key":"502_CR14","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1080\/02841860410002761","volume":"43","author":"X Mu","year":"2004","unstructured":"Mu X, Olofsson L, Karlsson M, et al: Can photon IMRT be improved by combination with mixed electron and photon techniques?. Acta Oncol. 2004, 43: 727-35. 10.1080\/02841860410002761.","journal-title":"Acta Oncol"},{"key":"502_CR15","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1109\/IEMBS.2006.260471","volume":"1","author":"MF Chan","year":"2006","unstructured":"Chan MF, Song Y, Burman C, et al: The treatment of extensive scalp lesions combining electrons with intensity-modulated photons. Conf Proc IEEE Eng Med Biol Soc. 2006, 1: 152-5.","journal-title":"Conf Proc IEEE Eng Med Biol Soc"},{"key":"502_CR16","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.radonc.2006.04.007","volume":"79","author":"MF Chan","year":"2006","unstructured":"Chan MF, Chui CS, Song Y, et al: A novel radiation therapy technique for malignant pleural mesothelioma combining electrons with intensity-modulated photons. Radiother Oncol. 2006, 79: 218-23. 10.1016\/j.radonc.2006.04.007.","journal-title":"Radiother Oncol"},{"issue":"Suppl 3","key":"502_CR17","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3171\/jns.2000.93.supplement_3.0219","volume":"93","author":"I Paddick","year":"2000","unstructured":"Paddick I: A simple scoring ratio to index the conformity of radiosurgical treatment plans. Technical note. J Neurosurg. 2000, 93 (Suppl 3): 219-22.","journal-title":"J Neurosurg"},{"key":"502_CR18","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1016\/0360-3016(89)90972-3","volume":"16","author":"GJ Kutcher","year":"1989","unstructured":"Kutcher GJ, Burman C: Calculation of complication probability factors for non-uniform normal tissue irradiation: the effective volume method. Int J Radiat Oncol Biol Phys. 1989, 16: 1623-30. 10.1016\/0360-3016(89)90972-3.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"502_CR19","doi-asserted-by":"publisher","first-page":"S13","DOI":"10.2307\/3583506","volume":"8","author":"JT Lyman","year":"1985","unstructured":"Lyman JT: Complication probability as assessed from dose-volume histograms. Radiat Res Suppl. 1985, 8: S13-9.","journal-title":"Radiat Res Suppl"},{"key":"502_CR20","volume-title":"Basic Clinical Radiobiology","author":"GG Steel","year":"2002","unstructured":"Steel GG: Basic Clinical Radiobiology. 2002, London, UK: Oxford University Press"},{"key":"502_CR21","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1016\/S0360-3016(01)01717-5","volume":"51","author":"JM Roesink","year":"2001","unstructured":"Roesink JM, Moerland MA, Battermann JJ, et al: Quantitative dose-volume response analysis of changes in parotid gland function after radiotherapy in the head-and-neck region. Int J Radiat Oncol Biol Phys. 2001, 51: 938-46. 10.1016\/S0360-3016(01)01717-5.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"502_CR22","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/S0360-3016(99)00247-3","volume":"45","author":"A Eisbruch","year":"1999","unstructured":"Eisbruch A, Ten Haken RK, Kim HM, et al: Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer. Int J Radiat Oncol Biol Phys. 1999, 45: 577-87. 10.1016\/S0360-3016(99)00247-3.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"502_CR23","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1118\/1.598729","volume":"26","author":"CM Ma","year":"1999","unstructured":"Ma CM, Mok E, Kapur A, et al: Clinical implementation of a Monte Carlo treatment planning system. Med Phys. 1999, 26: 2133-43. 10.1118\/1.598729.","journal-title":"Med Phys"},{"key":"502_CR24","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1088\/0031-9155\/32\/9\/001","volume":"32","author":"J Cygler","year":"1987","unstructured":"Cygler J, Battista JJ, Scrimger JW, et al: Electron dose distributions in experimental phantoms: a comparison with 2D pencil beam calculations. Phys Med Biol. 1987, 32: 1073-86. 10.1088\/0031-9155\/32\/9\/001.","journal-title":"Phys Med Biol"},{"key":"502_CR25","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1118\/1.596697","volume":"18","author":"AS Shiu","year":"1991","unstructured":"Shiu AS, Hogstrom KR: Pencil-beam redefinition algorithm for electron dose distributions. Med Phys. 1991, 18: 7-18. 10.1118\/1.596697.","journal-title":"Med Phys"},{"key":"502_CR26","doi-asserted-by":"publisher","first-page":"2096","DOI":"10.1118\/1.1406521","volume":"28","author":"RA Boyd","year":"2001","unstructured":"Boyd RA, Hogstrom KR, Starkschall G: Electron pencil-beam redefinition algorithm dose calculations in the presence of heterogeneities. Med Phys. 2001, 28: 2096-104. 10.1118\/1.1406521.","journal-title":"Med Phys"},{"key":"502_CR27","volume-title":"Master's Thesis: Louisiana State University, Baton Rouge, USA","author":"J Kavanaugh","year":"2011","unstructured":"Kavanaugh J: Evaluation of the pencil beam algorithm and pencil beam redefinition algorithm for bolus electron conformal therapy dose computation. Master's Thesis: Louisiana State University, Baton Rouge, USA. 2011, [http:\/\/etd.lsu.edu\/docs\/available\/etd-07062011-175440\/]"},{"key":"502_CR28","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1120\/1.1621494","volume":"4","author":"RJ Kudchadker","year":"2003","unstructured":"Kudchadker RJ, Antolak JA, Morrison WH, et al: Utilization of custom electron bolus in head and neck radiotherapy. J Appl Clin Med Phys. 2003, 4: 321-33. 10.1120\/1.1621494.","journal-title":"J Appl Clin Med Phys"},{"key":"502_CR29","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S0360-3016(02)02811-0","volume":"53","author":"RJ Kudchadker","year":"2002","unstructured":"Kudchadker RJ, Hogstrom KR, Garden AS, et al: Electron conformal radiotherapy using bolus and intensity modulation. Int J Radiat Oncol Biol Phys. 2002, 53: 1023-37. 10.1016\/S0360-3016(02)02811-0.","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1748-717X-6-178.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T18:20:03Z","timestamp":1630520403000},"score":1,"resource":{"primary":{"URL":"https:\/\/ro-journal.biomedcentral.com\/articles\/10.1186\/1748-717X-6-178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,12]]}},"alternative-id":["502"],"URL":"https:\/\/doi.org\/10.1186\/1748-717x-6-178","relation":{},"ISSN":["1748-717X"],"issn-type":[{"value":"1748-717X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12]]},"assertion":[{"value":"20 October 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2011","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2011","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"178"}}