Study for reducing lung dose of upper thoracic esophageal cancer radiotherapy by auto-planning: volumetric-modulated arc therapy vs intensity-modulated radiation therapy

Journal Article · Sat Sep 15 04:00:00 EDT 2018 · Medical Dosimetry

DOI:https://doi.org/10.1016/J.MEDDOS.2017.09.001· OSTI ID:22824200

Chen, Hua; Wang, Hao; Gu, Hengle; Shao, Yan; Cai, Xuwei; Fu, Xiaolong; Xu, Zhiyong ^[1]

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1. Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai (China)

This study aimed to investigate the dosimetric differences and lung sparing between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) in the treatment of upper thoracic esophageal cancer with T3N0M0 for preoperative radiotherapy by auto-planning (AP). Sixteen patient cases diagnosed with upper thoracic esophageal cancer T3N0M0 for preoperative radiotherapy were retrospectively studied, and 3 plans were generated for each patient: full arc VMAT AP plan with double arcs, partial arc VMAT AP plan with 6 partial arcs, and conventional IMRT AP plan. A simultaneous integrated boost with 2 levels was planned in all patients. Target coverage, organ at risk sparing, treatment parameters including monitor units and treatment time (TT) were evaluated. Wilcoxon signed-rank test was used to check for significant differences (p 20), 25 Gy (V{sub 25}), 30 Gy (V{sub 30}), 35 Gy (V{sub 35}), 40 Gy (V{sub 40}), and without increasing the value of V{sub 10}, V{sub 13}, and V{sub 15}. For V{sub 5} of total lung value, pVMAT was similar to aIMRT, and it was better than fVMAT. Both pVMAT and fVMAT improved the target dose coverage and significantly decreased maximum dose for the spinal cord, monitor unit, and TT. No significant difference was observed with respect to V{sub 10} and V{sub 15} of body. VMAT AP plan was a good option for treating upper thoracic esophageal cancer with T3N0M0, especially partial arc VMAT AP plan. It had the potential to effectively reduce lung dose in a shorter TT and with superior target coverage and dose homogeneity.

• OSTI ID: 22824200
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 3 Vol. 43; ISSN 0958-3947
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DIAGNOSIS
ESOPHAGUS
LUNGS
NEOPLASMS
PATIENTS
PLANNING
PNEUMONITIS
RADIATION DOSES
RADIOTHERAPY
SPINAL CORD