Dosimetric and efficiency comparison of high‐dose radiotherapy for esophageal cancer: volumetric modulated arc therapy versus fixed‐field intensity‐modulated radiotherapy. Issue 6 (18th October 2013)

• Record Type: Journal Article
• Authors: Lin, C.‐Y.; Huang, W.‐Y.; Jen, Y.‐M.; Chen, C.‐M.; Su, Y.‐F.; Chao, H.‐L.; Lin, C.‐S.
• Is Part Of: Diseases of the esophagus. Volume 27:Issue 6(2014)
• Page Start: 585
• Page End: 590
• Publication Date: 2013-10-18
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1111/dote.12144
• Languages: English
• ISSNs: 1120-8694

Abstract

<abstract abstract-type="main"> <title>Summary</title> <p>The aim of this study was to compare high‐dose volumetric modulated arc therapy (VMAT) and fixed‐field intensity‐modulated radiotherapy (ff‐IMRT) plans for the treatment of patients with middle‐thoracic esophageal cancer. Eight patients with cT2‐3N0M0 middle‐thoracic esophageal cancer were enrolled. The treatment planning system was the version 9 of the Pinnacle<sup>3</sup> with SmartArc (Philips Healthcare, Fitchburg, WI, USA). VMAT and ff‐IMRT treatment plans were generated for each case, and both techniques were used to deliver 50 Gy to the planning target volume (PTV<sub>50</sub>) and then provided a 16‐Gy boost (PTV<sub>66</sub>). The VMAT plans provided superior PTV<sub>66</sub> coverage compared with the ff‐IMRT plans (<italic>P</italic> = 0.034), whereas the ff‐IMRT plans provided more appropriate dose homogeneity to the PTV<sub>50</sub> (<italic>P</italic> = 0.017). In the lung, the V<sub>5</sub> and V<sub>10</sub> were lower for the ff‐IMRT plans than for the VMAT plans, whereas the V<sub>20</sub> was lower for the VMAT plans. The delivery time was significantly shorter for the VMAT plans than for the ff‐IMRT plans (<italic>P</italic> = 0.012). In addition, the VMAT plans delivered fewer monitor units. The VMAT technique required a shorter planning time than the ff‐IMRT technique (3.8 ± 0.8 hours vs. 5.4 ± 0.6 hours, <italic>P</italic> = 0.011). The major advantages of VMAT plans are higher efficiency and an approximately 50% reduction in delivery time compared with the ff‐IMRT plans, with comparable plan quality. Further clinical investigations to evaluate the use of high‐dose VMAT for the treatment of esophageal cancer are warranted.</p> </abstract>