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Dosimetric comparison of single-arc/partial-arc volumetric modulated arc therapy and intensity-modulated radiotherapy for peripheral and central lung cancer
Melek Akcay, Durmus Etiz, Kerem Duruer, Ozge Bozdogan, Alaattin Ozen
Department of Radiation Oncology, Medical Faculty of Osmangazi University, Eskisehir, Turkey
Correspondence Address:
Melek Akcay,
Department of Radiation Oncology, Medical Faculty of Osmangazi University, Odunpazari Eskisehir
Turkey
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jcrt.JCRT_221_19
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Aim: The aim of this study is to compare the differences between intensity-modulated radiotherapy (IMRT) and single-arc/partial-arc volumetric modulated arc therapy (SA/PA-VMAT) techniques in locally advanced-stage non-small cell lung cancer (NSCLC).
Materials and Methods: Locally advanced 22 patients with NSCLC were evaluated retrospectively. Each patient underwent radiation therapy with either IMRT or SA-VMAT or 2PA-VMAT technique. Homogeneity index, conformity number, and dosimetric parameters were evaluated.
Results: Ten peripheral and 12 central lung tumors were evaluated. In the entire patient group, tV5-10-60, total mean lung dose (tMLD), iV5-10-30-50-60, iMLD, and esophagus Dmean and Dmax were lower in IMRT technique, cV5-10-20-30, kMLD, and medulla spinalis Dmax were lower in PA-VMAT technique, whereas iMLD is the highest in the SA-VMAT technique. In peripheral tumors, tV5-10-60, iV5-10-20-30-40-60, iMLD, and esophagus Dmean were lower in IMRT technique and kV5-10 was lower in the 2PA-VMAT technique. In central tumors, tV5-10, tMLD, iV5-60, iMLD, and esophagus Dmean and Dmax were lower in IMRT technique, whereas cV10-20 and medulla spinalis Dmax were lower in 2PA-VMAT, and all contralateral lung doses are high in the SA-VMAT technique (all P < 0.05).
Conclusion: IMRT and VMAT techniques have different advantages in locally advanced lung cancer, and the use of those two techniques as a hybrid can provide a single collection of these advantages.
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