Study on esophageal cancer radiotherapy dosimetry and position verification for volumetric modulated arc therapy

Asian J Surg. 2023 Jan;46(1):120-125. doi: 10.1016/j.asjsur.2022.02.001. Epub 2022 Feb 25.

Abstract

Background: This study analyzed the respective advantages and disadvantages by comparing volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) on the dose distribution and position verification distribution characteristics in esophageal cancer radiotherapy, in order to provide the reference for the clinical radiotherapy technology optimization of esophageal cancer.

Methods: A total of 56 cases of patients with esophageal cancer were selected and applied to the Pinnacle three-dimensional radiation treatment planning system (TPS), in order to design a VMAT plan and IMRT plan under the guidance of image-guided radiotherapy (IGRT). The dosimetry and position verification difference were compared between the two groups.

Results: Revealed that the target dose distribution of the VMAT plan and IMRT plan meets the requirements in clinical dosimetry for all 56 patients in this study. Under the premise of similar target coverage, the conformal index (CI) of the VMAT plan, homogeneity index (HI), target volume, BODY-PTV radiated volume and spinal cord Dmax, bilateral lung V5, V20 and mean lung dose (MLD), monitor unit (MU) and treatment time (TT), as well as position verification and others, were obviously superior to those in the IMRT plan; and the difference was statistically significant.

Conclusion: CBCT guided VMAT is a potential effective treatment for esophageal cancer and may be more effective and safer than IMRT.

Keywords: Image guided; Position verification; Treatment planning system; Volume rotation intensity.

MeSH terms

  • Esophageal Neoplasms* / diagnostic imaging
  • Esophageal Neoplasms* / radiotherapy
  • Humans
  • Lung
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Radiotherapy, Intensity-Modulated* / methods