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Title: Evaluations of secondary cancer risk in spine radiotherapy using 3DCRT, IMRT, and VMAT: A phantom study

This study evaluated the secondary cancer risk from volumetric-modulated arc therapy (VMAT) for spine radiotherapy compared with intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal radiotherapy (3DCRT). Computed tomography images of an Radiological Physics Center spine anthropomorphic phantom were exported to a treatment planning system (Pinnacle{sup 3}, version 9.4). Radiation treatment plans for spine were prepared using VMAT (dual-arc), 7-field IMRT (beam angles: 110°, 130°, 150°, 180°, 210°, 230°, and 250°), and 4-field 3DCRT technique. The mean and maximum doses, dose-volume histograms, and volumes receiving more than 2 and 4 Gy to organs at risk (OARs) were calculated and compared. The lifetime risk for secondary cancers was estimated according to the National Cancer Registry Programme Report 116. VMAT delivered the lowest maximum dose to the esophagus (4.03 Gy), bone (8.11 Gy), heart (2.11 Gy), spinal cord (6.45 Gy), and whole lung (5.66 Gy) as compared with other techniques (IMRT and 3DCRT). The volumes of OAR (esophagus) receiving more than 4 Gy were 0% for VMAT, 27.06% for IMRT, and up to 32.35% for 3DCRT. The estimated risk for secondary cancer in the respective OAR is considerably lower in VMAT compared with other techniques. The results of maximum doses and volumes of OARsmore » suggest that the risk of secondary cancer induction for the spine in VMAT is lower than IMRT and 3DCRT, whereas VMAT has the best target coverage compared with the other techniques.« less
Authors:
 [1] ;  [2] ;  [3] ;  [1] ;  [4] ;  [1] ;  [5] ;  [3]
  1. Department of Physics, The Islamia University of Bahawalpur, Bahawalpur (Pakistan)
  2. (United States)
  3. Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX (United States)
  4. (Canada)
  5. Princess Margaret Cancer Center, University Health Network, Toronto, Ontario (Canada)
Publication Date:
OSTI Identifier:
22462428
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 40; Journal Issue: 1; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; ESOPHAGUS; HAZARDS; HEART; LUNGS; NEOPLASMS; PHANTOMS; PLANNING; RADIATION DOSES; RADIOTHERAPY; SPINAL CORD; THREE-DIMENSIONAL CALCULATIONS; VERTEBRAE