Dosimetric and efficiency comparison of high-dose radiotherapy for esophageal cancer: volumetric modulated arc therapy versus fixed-field intensity-modulated radiotherapy

作者：Lin C Y; Huang W Y; Jen Y M^*; Chen C M; Su Y F; Chao H L; Lin C S

来源：Diseases of the Esophagus, 2014, 27(6): 585-590.

DOI：10.1111/dote.12144

• dosimetric comparison
• esophageal cancer
• intensity-modulated radiotherapy
• volumetric modulated arc therapy

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(3) 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 (PTV50) and then provided a 16-Gy boost (PTV66). The VMAT plans provided superior PTV66 coverage compared with the ff-IMRT plans (P = 0.034), whereas the ff-IMRT plans provided more appropriate dose homogeneity to the PTV50 (P = 0.017). In the lung, the V-5 and V-10 were lower for the ff-IMRT plans than for the VMAT plans, whereas the V-20 was lower for the VMAT plans. The delivery time was significantly shorter for the VMAT plans than for the ff-IMRT plans (P = 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, P = 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.

• 出版日期2014-8
• 单位长春大学