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Treatment planning for non-small cell lung tumours: VMAT versus 3DCRT a quantitative dosimetric study

Published online by Cambridge University Press:  25 November 2019

Ahmed Hadj Henni Open the ORCID record for Ahmed Hadj Henni [Opens in a new window] ,
Yann Lauzin ,
Nicolas Pirault ,
Brian Dubos ,
Maximilien Roge ,
Perrine Clarisse ,
David Gensanne  and
Sebastien Thureau
Ahmed Hadj Henni*
Affiliation:
Centre Henri Becquerel, Rouen, France
Yann Lauzin
Affiliation:
Centre Henri Becquerel, Rouen, France
Nicolas Pirault
Affiliation:
Centre Henri Becquerel, Rouen, France
Brian Dubos
Affiliation:
Centre Henri Becquerel, Rouen, France
Maximilien Roge
Affiliation:
Centre Henri Becquerel, Rouen, France
Perrine Clarisse
Affiliation:
Centre Henri Becquerel, Rouen, France
David Gensanne
Affiliation:
Centre Henri Becquerel, Rouen, France
Sebastien Thureau
Affiliation:
Centre Henri Becquerel, Rouen, France
*
Author for correspondence: Ahmed Hadj Henni, Centre Henri Becquerel, 1 rue d’Amiens 76000, Rouen, France. Tel: +33(0)2 32 08 25 85. E-mail: ahmed.hadj-henni@chb.unicancer.fr
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Abstract

Purpose:

The dosimetric impact of volumetric modulated arc therapy (VMAT) in lung cancer compared with 3D conformal radiotherapy (3DCRT) is well known. However, this improvement is often associated with an increase in low doses. The aim of this study is to quantify these results more accurately.

Methods:

For each patient treated with 3DCRT, a second VMAT treatment plan was calculated. Usual dosimetric parameters such as target coverage or dose to the organs at risk were used to achieve the comparisons.

Results:

For planning target volume, homogeneity and conformity indices showed superiority of VMAT (respectively 0·07 and 0·87) compared to 3DCRT (0·11 and 0·57). For spinal cord planning organ at risk volume, the median maximum dose was 45·6 Gy in 3DCRT against 19·3 Gy in VMAT. Heart volume receiving at least 35 Gy (V35) decreased from 15·64% in 3DCRT to 8·28% in VMAT. Oesophagus V50 was higher in 3DCRT (25·45%) than in VMAT (14·03%). The mean lung dose was 17·9 Gy in 3DCRT versus 15·5 Gy in VMAT. Moreover, volumes receiving 5, 10 and 15 Gy were not significantly different between the two techniques when VMAT was performed with partial arcs.

Conclusion:

All the dosimetric parameters were improved with VMAT compared to the 3DCRT without increasing low doses when using partial arcs.

Keywords

3D conformal radiotherapylow dose volumesnon-small cell lung cancervolumetric modulated arc therapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 4 , December 2020 , pp. 327 - 332
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Copyright
© Cambridge University Press 2019

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