Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T20:51:48.301Z Has data issue: false hasContentIssue false
  • English
  • Français

Dosimetric comparison of helical tomotherapy and hybrid (3DCRT-VMAT) technique for locally advanced non-small cell lung cancer

Published online by Cambridge University Press:  22 May 2020

Öztun Temelli Open the ORCID record for Öztun Temelli [Opens in a new window] ,
Mehmet Demirtas Open the ORCID record for Mehmet Demirtas [Opens in a new window]  and
Berat Tugrul Ugurlu Open the ORCID record for Berat Tugrul Ugurlu [Opens in a new window]
Öztun Temelli*
Affiliation:
Inonu University, Malatya, Turkey
Mehmet Demirtas
Affiliation:
Inonu University, Malatya, Turkey
Berat Tugrul Ugurlu
Affiliation:
Inonu University, Malatya, Turkey
*
Author for correspondence: Öztun Temelli, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

The purpose of the present study is to compare hybrid [three-dimensional conformal radiation therapy-volumetric-modulated arc therapy (3DCRT-VMAT)] and helical tomotherapy (HT) techniques in terms of both planning target volume (PTV) and organs at risk (OARs) in the plans we made in locally advanced non-small cell lung cancer (NSCLC) patients

Material and methods:

Radiotherapy was planned for 15 locally advanced NSCLC patients with 2 different techniques. Large tumours with positive mediastinal lymph nodes were preferred. The prescription dose was determined as 60 Gy at 30 fractions.

Results:

Mean PTV volume was 602·5 cc (range: 265–1461). Mean total lung volume was 4264 cc (range: 1885–6803). Homogeneity index, Dmean, Dmax, D2 and V105 were found to be lower in HT, V100, total monitor units (MU) and total beam on time were found to be lower in the hybrid plan. Total lung Dmean was found to be 17 Gy in both techniques. V10 value was 42·85 in the hybrid plan and 48·67 in HT (p = 0·037). Heart Dmean was 14·5 Gy in the hybrid plan and 18·7 in HT (p < 0·001), and V30 values were 18·1 and 22·9, respectively (p = 0·009).

Conclusion:

Suitable dose coverage and OAR doses can be provided with both techniques. Especially the opposite lung, heart and oesophagus doses can be kept lower with the hybrid plan, and lower MU and shorter beam on time can be provided.

Keywords

lung cancerhybrid techniquehelical tomotherapydosimetric comparison
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 300 - 305
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Chen, V W, Ruiz, B A, Hsieh, M C, et al. Analysis of stage and clinical/prognostic factors for lung cancer from SEER registries: AJCC staging and collaborative stage data collection system. Cancer 2014;120:3781–3792. doi: 10.1002/cncr.29045 CrossRefGoogle ScholarPubMed
Rami-Porta, R, Asamura, H, Travis, W D, et al. Lung cancer-major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2017;67:138–155.CrossRefGoogle Scholar
Postmus, P E, Kerr, K M, Oudkerk, M, et al. Peters S on behalf of the ESMO Guidelines Committee, Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017;28 (suppl_4): iv1–iv21. doi: 10.1093/annonc/mdx222 CrossRefGoogle Scholar
Ozawa, T, Koiwai, K, Matsushita, H, Kadoya, M. Dosimetric comparisons of volumetric modulated arc therapy with three-dimensional conformal radiation therapy for locally advanced non-small cell lung cancer. Shinshu Med J 2017; 65 (2):93–98. doi: 10.11441/shinshumedj.65.93 Google Scholar
Murshed, H., Liu, H H, Liao, Z, et al. Dose and volume reduction for normal lung using intensity-modulated radiotherapy for advanced-stage non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2004; 58 (4): 1258–1267. doi: 10.1016/j.ijrobp.2003.09.086 CrossRefGoogle ScholarPubMed
Pasler, M, Georg, D, Bartelt, S, Lutterbach, J. Node-positive left-sided breast cancer: does VMAT improve treatment plan quality with respect to IMRT? Strahlentherapie und Onkol 2013; 189 (5): 380–386. doi: 10.1007/s00066-012-0281-2 CrossRefGoogle ScholarPubMed
Zhu, Z, Fu, X. The radiation techniques of tomotherapy & intensity-modulated radiation therapy applied to lung cancer. Transl Lung Cancer Res 2015; 4 (3): 265–274. doi: 10.3978/j.issn.2218-6751.2015.01.07 Google ScholarPubMed
http://www.rtog.org/CoreLab/ContouringAtlases/LungAtlas.aspx. Accessed on 1 January 2020.Google Scholar
NRG ONCOLOGY RTOG 1306. A Randomized Phase II Study of Individualized Combined Modality Therapy For Stage III Non-Small Cell Lung Cancer (NSCLC). http://www.clinicaltrials.gov//. Accessed on 1 January 2020.Google Scholar
Kataria, T, Sharma, K, Subramani, V, et al. Homogeneity Index: an objective tool for assessment of conformal radiation treatments. J Med Phys 2012; 37 (4): 207–213.CrossRefGoogle ScholarPubMed
MacFarlane, M, Hoover, D A, Wong, E, et al. Evaluation of unified intensity-modulated arc therapy for the radiotherapy of head-and-neck cancer. Radiother Oncol 2016; 119: 331–336.CrossRefGoogle ScholarPubMed
Aoyama, H, Westerly, D C, Mackie, T R, et al. Integral radiation dose to normal structures with conformal external beam radiation. Int J Radiat Oncol Biol Phys 2006; 64 (3): 962–967.CrossRefGoogle ScholarPubMed
Graham, M V, Purdy, J A, Emami, B, et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys 1999; 45: 323–329.CrossRefGoogle Scholar
Palma, D A, Senan, S, Tsujino, K, Barriger, R B, Rengan, R, Moreno, M, et al. Predicting radiation pneumonitis after chemoradiation therapy for lung cancer: an international individual patient data metaanalysis. Int J Radiat Oncol Biol Phys 2013;85:444–50.CrossRefGoogle Scholar
Kristensen, C A, Nottrup, T J, Berthelsen, A K, et al. Pulmonary toxicity following IMRT after extrapleural pneumonectomy for malignant pleural mesothelioma. Radiother Oncol 2009; 92: 969.CrossRefGoogle ScholarPubMed
Xu, Y, Deng, W, Yang, S, et al. Dosimetric comparison of the helical tomotherapy, volumetric-modulated arc therapy and fixed-field intensity-modulated radiotherapy for stage IIB-IIIB non-small cell lung cancer. Sci Rep 2009; 7: 14863. doi: 10.1038/s41598-017-14629-w CrossRefGoogle Scholar
Vojtíšek, R. Cardiac toxicity of lung cancer radiotherapy. Rep Pract Oncol Radiother. 2020; 25 (1): 13–19. doi: 10.1016/j.rpor.2019.10.007 CrossRefGoogle ScholarPubMed
Speirs, C K, DeWees, T A, Rehman, S, et al. Heart dose is an independent dosimetric predictor of overall survival in locally advanced non-small cell lung cancer. J Thorac Oncol. 2017; 12 (2): 293–301. doi: 10.1016/j.jtho.2016.09.134 Google ScholarPubMed
Kim, S J, Lee, J W, Kang, M K, et al. Evaluation of the hybrid dynamic conformal arc therapy technique for radiotherapy of lung cancer. Radiat Oncol J 2018; 36 (3): 241–247. doi: 10.3857/roj.2018.00171 CrossRefGoogle ScholarPubMed
Huang, E X, Bradley, J D, El Naqa, I, et al. Modeling the risk of radiation-induced acute esophagitis for combined Washington University and RTOG trial 93–11 lung cancer patients. Int J Radiat Oncol Biol Phys 2012; 82: 1674–1679.CrossRefGoogle ScholarPubMed
Palma, D A, Senan, S, Oberije, C, et al. Predicting esophagitis after chemoradiation therapy for non-small cell lung cancer: an individual patient data meta-analysis. Int J Radiat Oncol Biol Phys 2013; 87 (4): 690–696. doi: 10.1016/j.ijrobp.2013.07.029 CrossRefGoogle ScholarPubMed