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Dosimetric comparison of coplanar and non-coplanar volumetric-modulated arc therapy in head and neck cancer treated with radiotherapy

Radiation Oncology Journal 2020년 38권 2호 p.138 ~ 147
Gayen Sanjib, Kombathula Sri Harsha, Manna Sumanta, Varshney Sonal, Pareek Puneet,
소속 상세정보
 ( Gayen Sanjib ) - All India Institute of Medical Sciences Department of Radiation Oncology
 ( Kombathula Sri Harsha ) - All India Institute of Medical Sciences Department of Radiation Oncology
 ( Manna Sumanta ) - All India Institute of Medical Sciences Department of Radiation Oncology
 ( Varshney Sonal ) - All India Institute of Medical Sciences Department of Radiation Oncology
 ( Pareek Puneet ) - All India Institute of Medical Sciences Department of Radiation Oncology

Abstract


Purpose: To evaluate the dosimetric variations in patients of head and neck cancer treated with definitive or adjuvant radiotherapy using optimized non-coplanar (ncVMAT) beams with coplanar (cVMAT) beams using volumetric arc therapy.

Materials and Methods: Twenty-two patients of head and neck cancer that had received radiotherapy using VMAT in our department were retrospectively analyzed. Each of the patients was planned using coplanar and non-coplanar orientations using an optimized couch angle and fluences. We analyzed the Conformity Index (CIRTOG), Dose Homogeneity Index (DHI), Heterogeneity Index (HIRTOG), low dose volume, target and organs-at-risk coverage in both the plans without changing planning optimization parameters.

Results: The prescription dose ranged from 60 Gy to 70 Gy. Using ncVMAT, CIRTOG, DHI and HIRTOG, and tumor coverage (ID95%) had improved, low dose spillage volume in the body V5Gy was increased and V10Gy was reduced. Integral dose and intensity-modulated radiation therapy factor had increased in ncVMAT. In the case of non-coplanar beam arrangements, maximum dose (Dmax) of right and left humeral head were reduced significantly whereas apex of the right and left lung mean dose were increased.

Conclusion: The use of ncVMAT produced better target coverage and sparing of the shoulder and soft tissue of the neck as well as the critical organ compared with the cVMAT in patients of head and neck malignancy.

키워드

Head and neck neoplasm; Intensity-modulated radiotherapy

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