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Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer

OBJECTIVE: To compare plans using volumetric-modulated arc therapy (VMAT) with conventional sliding window intensity-modulated radiation therapy (c-IMRT) to treat upper thoracic esophageal cancer (EC). METHODS: CT datasets of 11 patients with upper thoracic EC were identified. Four plans were genera...

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Autores principales: Zhang, Wu-Zhe, Zhai, Tian-Tian, Lu, Jia-Yang, Chen, Jian-Zhou, Chen, Zhi-Jian, Li, De-Rui, Chen, Chuang-Zhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376741/
https://www.ncbi.nlm.nih.gov/pubmed/25815477
http://dx.doi.org/10.1371/journal.pone.0121385
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author Zhang, Wu-Zhe
Zhai, Tian-Tian
Lu, Jia-Yang
Chen, Jian-Zhou
Chen, Zhi-Jian
Li, De-Rui
Chen, Chuang-Zhen
author_facet Zhang, Wu-Zhe
Zhai, Tian-Tian
Lu, Jia-Yang
Chen, Jian-Zhou
Chen, Zhi-Jian
Li, De-Rui
Chen, Chuang-Zhen
author_sort Zhang, Wu-Zhe
collection PubMed
description OBJECTIVE: To compare plans using volumetric-modulated arc therapy (VMAT) with conventional sliding window intensity-modulated radiation therapy (c-IMRT) to treat upper thoracic esophageal cancer (EC). METHODS: CT datasets of 11 patients with upper thoracic EC were identified. Four plans were generated for each patient: c-IMRT with 5 fields (5F) and VMAT with a single arc (1A), two arcs (2A), or three arcs (3A). The prescribed doses were 64 Gy/32 F for the primary tumor (PTV64). The dose-volume histogram data, the number of monitoring units (MUs) and the treatment time (TT) for the different plans were compared. RESULTS: All of the plans generated similar dose distributions for PTVs and organs at risk (OARs), except that the 2A- and 3A-VMAT plans yielded a significantly higher conformity index (CI) than the c-IMRT plan. The CI of the PTV64 was improved by increasing the number of arcs in the VMAT plans. The maximum spinal cord dose and the planning risk volume of the spinal cord dose for the two techniques were similar. The 2A- and 3A-VMAT plans yielded lower mean lung doses and heart V(50) values than the c-IMRT. The V(20) and V(30) for the lungs in all of the VMAT plans were lower than those in the c-IMRT plan, at the expense of increasing V(5), V(10) and V(13). The VMAT plan resulted in significant reductions in MUs and TT. CONCLUSION: The 2A-VMAT plan appeared to spare the lungs from moderate-dose irradiation most effectively of all plans, at the expense of increasing the low-dose irradiation volume, and also significantly reduced the number of required MUs and the TT. The CI of the PTVs and the OARs was improved by increasing the arc-number from 1 to 2; however, no significant improvement was observed using the 3A-VMAT, except for an increase in the TT.
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spelling pubmed-43767412015-04-04 Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer Zhang, Wu-Zhe Zhai, Tian-Tian Lu, Jia-Yang Chen, Jian-Zhou Chen, Zhi-Jian Li, De-Rui Chen, Chuang-Zhen PLoS One Research Article OBJECTIVE: To compare plans using volumetric-modulated arc therapy (VMAT) with conventional sliding window intensity-modulated radiation therapy (c-IMRT) to treat upper thoracic esophageal cancer (EC). METHODS: CT datasets of 11 patients with upper thoracic EC were identified. Four plans were generated for each patient: c-IMRT with 5 fields (5F) and VMAT with a single arc (1A), two arcs (2A), or three arcs (3A). The prescribed doses were 64 Gy/32 F for the primary tumor (PTV64). The dose-volume histogram data, the number of monitoring units (MUs) and the treatment time (TT) for the different plans were compared. RESULTS: All of the plans generated similar dose distributions for PTVs and organs at risk (OARs), except that the 2A- and 3A-VMAT plans yielded a significantly higher conformity index (CI) than the c-IMRT plan. The CI of the PTV64 was improved by increasing the number of arcs in the VMAT plans. The maximum spinal cord dose and the planning risk volume of the spinal cord dose for the two techniques were similar. The 2A- and 3A-VMAT plans yielded lower mean lung doses and heart V(50) values than the c-IMRT. The V(20) and V(30) for the lungs in all of the VMAT plans were lower than those in the c-IMRT plan, at the expense of increasing V(5), V(10) and V(13). The VMAT plan resulted in significant reductions in MUs and TT. CONCLUSION: The 2A-VMAT plan appeared to spare the lungs from moderate-dose irradiation most effectively of all plans, at the expense of increasing the low-dose irradiation volume, and also significantly reduced the number of required MUs and the TT. The CI of the PTVs and the OARs was improved by increasing the arc-number from 1 to 2; however, no significant improvement was observed using the 3A-VMAT, except for an increase in the TT. Public Library of Science 2015-03-27 /pmc/articles/PMC4376741/ /pubmed/25815477 http://dx.doi.org/10.1371/journal.pone.0121385 Text en © 2015 Zhang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Zhang, Wu-Zhe
Zhai, Tian-Tian
Lu, Jia-Yang
Chen, Jian-Zhou
Chen, Zhi-Jian
Li, De-Rui
Chen, Chuang-Zhen
Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer
title Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer
title_full Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer
title_fullStr Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer
title_full_unstemmed Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer
title_short Volumetric Modulated Arc Therapy vs. c-IMRT for the Treatment of Upper Thoracic Esophageal Cancer
title_sort volumetric modulated arc therapy vs. c-imrt for the treatment of upper thoracic esophageal cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376741/
https://www.ncbi.nlm.nih.gov/pubmed/25815477
http://dx.doi.org/10.1371/journal.pone.0121385
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