A dosimetric comparison of volumetric modulated arc therapy with intensity modulated radiation therapy for head and neck cancer

doi:10.3760/cma.j.cn371439-20200224-00057

Abstract

Abstract:

Objective To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) for head and neck cancer. Methods From January 2019 to December 2019, 46 cases of patients with head and neck cancer confirmed by pathology in the First Affiliated Hospital of Anhui Medical University were selected. All patients underwent CT-simulation in supine position. Planning target volumes (PTVs) were delineated for two dose levels of PTV70 and PTV54 in 35 equal fraction. Simultaneous integrated boost plan was generated for all patients and optimized with both techniques, VMAT and IMRT with similar planning objectives. The dosimetry differences between the two plans were compared. Results The conformity index (CI)95% of PTV70 in VMAT plan was higher than that in IMRT plan (0.91±0.02 vs. 0.86±0.06), and the difference was statistically significant (t=4.933, P=0.004). The homogeneity index (HI)95% of PTV54 in VMAT plan was superior to that in IMRT (0.09±0.04 vs. 0.26±0.02), and the difference was statistically significant (t=4.548, P=0.038). The spinal cord D_1% of VMAT was lower than that in IMRT (37.62±4.34 vs. 40.93±7.45), and the difference was statistically significant (t=2.615, P=0.045). The dose of left parotid gland in VMAT was (21.28±8.13) Gy and the dose of right parotid gland was (22.39±7.42) Gy, which were slightly lower than those in IMRT [(22.73±11.42) Gy and (24.25±7.91) Gy], but the differences were not statistically significant (t=0.703, P=0.322; t=1.134, P=0.315). Compared with IMRT, VMAT could significantly reduce the number of monitor units (521±112 vs. 2 129±564), and could significantly shorten the treatment time of patients [(2.12±0.39) min vs. (9.18±2.62) min], and the differences were statistically significant (t=18.957, P<0.001; t=18.213, P<0.001). Conclusion The dose distribution of VMAT technology is better than IMRT, the dose of organ at risk is reduced, the monitor unit is lesser, and the treatment time is shorter.

Key words: Head and neck neoplasms, Radiotherapy,intensity-modulated, Radiotherapy dosage

Qian Wenchuan, Wang Fan. A dosimetric comparison of volumetric modulated arc therapy with intensity modulated radiation therapy for head and neck cancer[J]. Journal of International Oncology, 2020, 47(8): 457-461.

Figures/Tables 2

References 12

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参数	目标剂量	VMAT	IMRT	t值	P值
PTV70
均值(Gy)	70	70.52±1.34	71.73±1.12	4.825	0.005
D_2%(Gy)	<75	74.26±1.21	74.09±1.43	0.625	0.334
D_98%(Gy)	>66	67.42±1.14	67.35±1.31	0.279	0.356
D_50%(Gy)	70	71.82±1.36	70.65±1.13	4.781	0.032
D_80%(Gy)	70	70.55±1.27	69.43±1.42	4.123	0.041
V_107%	<2%	2.32±1.35	2.84±1.92	1.473	0.312
HI95%	0	0.09±0.03	0.10±0.05	1.047	0.319
CI95%	1	0.91±0.02	0.86±0.06	4.933	0.004
PTV54
D_2%(Gy)	<58	57.45±3.24	57.92±5.13	0.563	0.338
D_98%(Gy)	>51	51.61±2.34	51.46±2.52	0.399	0.341
D_50%(Gy)	50	54.62±1.45	54.12±1.83	1.487	0.281
HI95%	0	0.09±0.04	0.26±0.02	4.548	0.038

参数	目标剂量	VMAT	IMRT	t值	P值
脊髓
D_1%	<46	37.62±4.34	40.93±7.45	2.615	0.045
左腮腺
均值(Gy)	<26	21.28±8.13	22.73±11.42	0.703	0.322
V_{30 Gy}(%)	<45%	22.39±14.36	22.48±19.81	0.025	0.383
右腮腺
均值(Gy)	<26	22.39±7.42	24.25±7.91	1.134	0.315
V_{30 Gy}(%)	<45%	25.64±13.51	26.43±14.22	0.277	0.362
喉
均值(Gy)	<45	37.42±2.53	41.82±4.35	5.998	0.002
口腔
均值(Gy)	<30	28.14±4.53	32.61±3.46	5.411	0.003

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