Intensity-modulated radiotherapy and volumetric-modulated arc therapy have distinct clinical advantages in non-small cell lung cancer treatment

Jun Zhang, Xiao-Ling Yu, Guo-Feng Zheng, Fei Zhao
Medical Oncology 2015, 32 (4): 94
This study was conducted to compare the efficacy of intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) in delivering the planned dosage in the treatment of non-small cell lung cancer (NSCLC). Between September 2013 and March 2014, 125 NSCLC patients were randomly chosen and allocated to the IMRT group (n = 65) and VMAT group (n = 60). We compared multiple parameters such as target dose, organ dosimetry, monitor unit (MU) and time of therapy between IMRT and VMAT groups. The prescribed dose coverage of both planning techniques was 95 % of the planning target volumes (PTVs). PTV 95 % and homogeneous index in IMRT plan were greater than those in VMAT plan (both P < 0.05), while no significant difference in conformity index was observed (P > 0.05). The mean total lung V5 and V10 in VMAT group were markedly higher than those in IMRT group, but the V20, V30, and V40 in VMAT group were significantly lower (all P < 0.05), but no statistically significant difference was observed in V15 and V20 (P > 0.05). Furthermore, the planning spine and esophagus at risk volume showed no statistical significances in both groups (P > 0.05). MU of IMRT plan was about 4.2 % less than that of VMAT plan, which was statistically significant (P < 0.001). Both IMRT and VMAT had significant advantages in the treatment of NSCLC. The IMRT may be better for NSCLC patients with poor pulmonary function, and VMAT may be recommended for NSCLC patients with normal pulmonary function.

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