COMPARATIVE STUDY
JOURNAL ARTICLE

Stereotactic body radiotherapy: volumetric modulated arc therapy versus 3D non-coplanar conformal radiotherapy for the treatment of early stage lung cancer

C Herbert, W Kwa, S Nakano, K James, V Moiseenko, J Wu, D Schellenberg, M Liu
Technology in Cancer Research & Treatment 2013, 12 (6): 511-6
23617285
Stereotactic body radiotherapy (SBRT) is a treatment option for patients with early stage lung cancer. Treatment duration can be >30 minutes per fraction with non-coplanar 3D-conformal radiotherapy (3D-CRT). Whilst this is generally well tolerated, faster delivery techniques are desirable. Volumetric modulated arc therapy (VMAT) allows for fast delivery of radiation treatment. The purpose of this planning study was to compare SBRT with 3D-CRT and VMAT, with VMAT plans generated using both single arc and 3 non-coplanar partial arcs. Ten patients who previously underwent SBRT (48 Gy in 4 fractions) with 3D-CRT were selected. VMAT plans were generated to treat the PTV while limiting doses to organs at risk. Cumulative dose volume histogram (DVH) parameters were compared between the 3 techniques using the Wilcoxon matched pairs test. Treatment delivery time was also assessed. Both VMAT techniques covered target volumes more conformally than 3D-CRT with a mean V48/VPTV of 1.21 for 3D-CRT, 1.03 for 3 arc plans and 1.01 for single arc plans (p = 0.005). Dose constraints to organs at risk were met using all three techniques. Mean lung doses were 2.93 Gy for 3D-CRT, 2.87 Gy for single arc and 2.73 Gy for the 3 arc technique (3-arc vs. 3D-CRT: p = 0.009). Lung V20 for 3D-CRT, 1 arc and 3 arcs were 3.24%, 2.89% and 2.73%, respectively (3 arc vs. 3D-CRT: p = 0.028). Mean time to deliver a single fraction was 13 minutes for 3D-CRT, 9.2 minutes for 3 arcs and 5.5 minutes for 1 arc. VMAT resulted in improved conformality compared to 3D-CRT. The 3 arc technique appears to have the lowest dose to lung although the magnitude is unlikely to be clinically significant. The main advantage of VMAT over 3D-CRT is faster treatment delivery time. Shortened treatment times are anticipated to improve tolerability of this treatment and reduce the chance of error due to intra-fraction motion.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23617285
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"