Treating lung cancer with dynamic conformal arc therapy: a dosimetric study

Autor: Karmen Stanic, A. Strojnik, Primož Peterlin, Ignasi Mendez
Rok vydání: 2016
Předmět:
lcsh:Medical physics. Medical radiology. Nuclear medicine
Organs at Risk
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
lcsh:R895-920
Planning target volume
lcsh:RC254-282
030218 nuclear medicine & medical imaging
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Medicine
Dosimetry
Humans
Radiology
Nuclear Medicine and imaging
Lung volumes
Lung cancer
Radiometry
Mean lung dose
business.industry
Radiotherapy Planning
Computer-Assisted
Research
Significant difference
Radiotherapy Dosage
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
Dynamic conformal arc therapy
Radiation therapy
Oncology
Film dosimetry
030220 oncology & carcinogenesis
Dynamic conformal arc
Radiology
Radiotherapy
Conformal
business
Follow-Up Studies
Zdroj: Radiation Oncology (London, England)
Radiation Oncology, Vol 12, Iss 1, Pp 1-14 (2017)
ISSN: 1748-717X
Popis: Background Lung cancer patients are often in poor physical condition, and a shorter treatment time would reduce their discomfort. Dynamic conformal arc therapy (DCAT) offers a shorter treatment time than conventional 3D conformal radiotherapy (3D CRT) and is usually available even in departments without inverse planning possibilities. We examined its suitability as a treatment modality for lung cancer patients. Methods On a cohort of 35 lung cancer patients, relevant dosimetric parameters were compared in respective DCAT and 3D CRT treatment plans. Radiochromic film dosimetry in an anthropomorphic phantom was used to compare both DCAT and 3D CRT dose distributions against their planned counterparts. Results In comparison with their 3D CRT counterparts, DCAT plans equal or exceed the agreement between the calculated dose and the dose measured using film dosimetry. In dosimetric comparison, DCAT performed significantly better than 3D CRT in dose conformity to PTV and the number of monitor units used per plan, and significantly worse in dose homogeneity, mean lung dose and lung volume exposed to 5 Gy or more (V5Gy). No significant difference was found in the V20Gy value to lung, dose to 1 cm3 of spinal cord, and the mean dose to oesophagus. Improvements in V20Gy and V5Gy were found to be negatively correlated. DCAT plans differ from 3D CRT by exhibiting a moderate negative correlation between target volume sphericity and dose homogeneity. Conclusions With respect to the agreement between the planned and the irradiated dose distribution, DCAT appears at least as reliable as 3D CRT. In specific conditions concerning the patient anatomy and treatment prescription, DCAT may yield more favourable dosimetric parameters. On average, however, conventional 3D CRT usually obtains better dosimetric parameters. We can thus only recommend DCAT as a complementary technique to the conventional 3D CRT. Electronic supplementary material The online version of this article (doi:10.1186/s13014-017-0823-y) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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