Applications of IMAT in cervical esophageal cancer radiotherapy: a comparison with fixed‐field IMRT in dosimetry and implementation

This study aimed to compare fixed‐field, intensity‐modulated radiotherapy (f‐IMRT) with intensity‐modulated arc therapy (IMAT) treatment plans in dosimetry and practical application for cervical esophageal carcinoma. For ten cervical esophageal carcinoma cases, f‐IMRT plan (seven fixed‐fields) and two IMAT plans, namely RA (coplanar 360° arcs) and RAx (coplanar 360° arcs without sectors from 80° to 110°, and 250° to 280°), were generated. DVHs were adopted for the statistics of above parameters, as well as conformal index (CI), homogeneity index (HI), dose‐volumetric parameters of normal tissues, total accelerator output MUs and total treatment time. There were differences between RAx and f‐IMRT, as well as RA in PTV parameters such as HI, [Formula: see text] and [Formula: see text] , but not in CI. RAx reduced lung [Formula: see text] from ([Formula: see text] in f‐IMRT and ([Formula: see text] in RA to ([Formula: see text] in RAx [Formula: see text]. However, lung [Formula: see text] and MLD increased in RAx. There was no difference in the mean heart dose in three plans. Total MU was reduced from [Formula: see text] in f‐IMRT to [Formula: see text] in RA and [Formula: see text] in RAx [Formula: see text]. Compared with f‐IMRT, IMAT reduced low dose volumes of lung and total MU on the basis of meeting clinical requirements. PACS numbers: 87.55.D, 87.55.dk, 87.55.ne