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Abstract
Purpose: To compare the difference of dose distribution and physical characteristics on treatment plans using Three-Dimensional Conformal Radiation Therapy (3D-CRT), Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) techniques in the treatment of lung cancer using Stereotactic Body Radiation Therapy (SBRT).
Materials and method: 9 lung cancer patients who previously underwent with SBRT using VMAT on TrueBeam STx linear accelerator were selected. Average CT obtained from 4 Dimension Computed Tomography Simulation (4D-CT) of patients were used to plan on Eclipse v13.6 by 3D-CRT, IMRT, and VMAT (CP and NCP) techniques. The prescription dose 48Gy in 4 was delivered for the Planning Target Volume (PTV). All plans were optimized and evaluated based on the criteria in RTOG 0915 [1]. The dose distribution of OARs in DVH (Dose Volume Histogram) and the targets at Conformity Index (CI), Gradient Index (GI), Homogeneity Index (HI), Monitor Unit (MU) were used to comparing between conformal and modulated techniques.
Results: Using VMAT and IMRT, the volume conformity was better than 3D-CRT(p<0,01), reduced significant lung dose at V5 (p<0,05). VMAT improved skin dose (23%) than 3D-CRT and IMRT. However, 3D-CRT have much lower MU number than VMAT and IMRT techniques. There were no significant differences in OARs such as the heart, esophagus, spinal cord, chest wall.
Conclusions: VMAT improves the treatment volume coverage and significantly reduces the lung dose volume at V5 than 3D-CRT and IMRT techniques.
References
V. G.M. et al., Long-term follow-up on NRG oncology RTOG 0915 (NCCTG n0927): A randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer, vol. 99, no. 2. 2017.
A. Weyh, A. Konski, A. Nalichowski, J. Maier, and D. Lack, “Lung SBRT : dosimetric and delivery comparison of RapidArc, TomoTherapy, and IMRT,” J. Appl. Clin. Med. Phys., vol. 14, no. 4, pp. 3-13, 2013.
B. M. Rauschenbach, L. Mackowiak, and H. K. Malhotra, “A dosimetric comparison of three-dimensional conformal radiotherapy, volumetric-modulated arc therapy, and dynamic conformal arc therapy in the treatment of non,” J. Appl. Clin. Med. Phys., vol. 15, no. 5, pp. 147- 161, 2014.
G. Narayanasamy, D. Desai, S. Maraboyina, J. Penagaricano, R. Zwicker, and E. Johnson, “A dose falloff gradient study in RapidArc planning of lung stereotactic body radiation therapy,” J. Med. Phys., vol. 43, no. 3, p. 147, 2018.
M. Macià i Garau, “Radiobiology of stereotactic body radiation therapy (SBRT),” Reports Pract. Oncol. Radiother., vol. 22, no. 2, pp. 86-95, 2017.
Y. Nagata et al., “Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame,” Int. J. Radiat. Oncol. Biol. Phys., vol. 63, no. 5, pp. 1427-1431, 2005.
C. Hospital, “HE quest for a simple and universal scoring system,” J Neurosurg., vol. 93, no. Suppl 3, pp. 219-222, 2000.
C. L. Ong, W. F. A. R. Verbakel, J. P. Cuijpers, B. J. Slotman, F. J. Lagerwaard, and S. Senan, “Stereotactic radiotherapy for peripheral lung tumors: A comparison of volumetric modulated arc therapy with 3 other delivery techniques,” Radiother. Oncol., vol. 97, no. 3, pp. 437-442, 2010.
A. Holt, C. Van Vliet-Vroegindeweij, A. Mans, J. S. Belderbos, and E. M. F. Damen, “Volumetric- modulated arc therapy for stereotactic body radiotherapy of lung tumors: A comparison with intensity-modulated radiotherapy techniques,” Int. J. Radiat. Oncol. Biol. Phys., vol. 81, no. 5, pp. 1560-1567, 2011.
E. Shaw et al., “Radiation Therapy Oncology Group: Radiosurgery Quality Assurance Guidelines,” vol. l, no. August, 1993.
I. Paddick and B. Lippitz, “A simple dose gradient measurement tool to complement the conformity index,” J. Neurosurg., vol. 105, no. Supplement, pp. 194-201, 2006.
G. G. Zhang et al., “Volumetric modulated arc planning for lung stereotactic body radiotherapy using conventional and unflattened photon beams: A dosimetric comparison with 3D technique,” Radiat. Oncol., vol. 6, no. 1, p. 152, 2011.
C. C. Ross, J. J. Kim, Z. J. Chen, D. J. Grew, B. W. Chang, and R. H. Decker, “A novel modified dynamic conformal arc technique for treatment of peripheral lung tumors using stereotactic body radiation therapy,” Pract. Radiat. Oncol., vol. 1, no. 2, pp. 126-134, 2011.
| Published | 21-12-2020 | |
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| Issue | No. 66 (2020) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.2020.66.17 | |
| Keywords | Xạ trị lập thể định vị thân, 3D-CRT, IMRT, VMAT, ung thư phổi SBRT, 3D-CRT, IMRT, VMAT, lung cancer |
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