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Radiation Oncology Journal > Epub ahead of print
doi: https://doi.org/10.3857/roj.2017.00241    [Epub ahead of print]
Dosimetric comparison between modulated arc therapy and static intensity modulated radiotherapy in thoracic esophageal cancer: a single institutional experience
Kyu Hye Choi, Jina Kim, Sea-Won Lee, Young-nam Kang, HongSeok Jang
Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence  HongSeok Jang ,Tel: +82-2-2258-1526, Fax: +82-2-592-1532, Email: hsjang11@catholic.ac.kr
Received: 15 May 2017; Revised: 3 September 2017   Accepted: 27 September 2017.  Published online: 23 December 2017.
ABSTRACT
Purpose:
The objective of this study was to compare dosimetric characteristics of three-dimensional conformal radiotherapy (3D-CRT) and two types of intensity-modulated radiotherapy (IMRT) which are step-and-shoot intensity modulated radiotherapy (s-IMRT) and modulated arc therapy (mARC) for thoracic esophageal cancer and analyze whether IMRT could reduce organ-at-risk (OAR) dose.
Materials and Methods:
We performed 3D-CRT, s-IMRT, and mARC planning for ten patients with thoracic esophageal cancer. The dose-volume histogram for each plan was extracted and the mean dose and clinically significant parameters were analyzed.
Results:
Analysis of target coverage showed that the conformity index (CI) and conformation number (CN) in mARC were superior to the other two plans (CI, p = 0.050; CN, p = 0.042). For the comparison of OAR, lung V5 was lowest in s-IMRT, followed by 3D-CRT, and mARC (p = 0.033). s-IMRT and mARC had lower values than 3D-CRT for heart V30 (p = 0.039), V40 (p = 0.040), and V50 (p = 0.032).
Conclusion:
Effective conservation of the lung and heart in thoracic esophageal cancer could be expected when using s-IMRT. The mARC was lower in lung V10, V20, and V30 than in 3D-CRT, but could not be proven superior in lung V5. In conclusion, low-dose exposure to the lung and heart were expected to be lower in s-IMRT, reducing complications such as radiation pneumonitis or heart-related toxicities.
Keywords: Esophagus cancer, Intensity-modulated radiotherapy, Modulated arc (mARC) technique, Dosimetric comparison
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