1. Split X-Jaw techniques of volumetric modulated arc radiotherapy in nasopharyngeal cancer: A dosimetric comparison.
- Author
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Nath, Jyotiman, Sarma, Gautam, Goswami, Shachindra, Sharma, Shashi Bhushan, Goswami, Pranjal, and Kalita, Apurba Kumar
- Subjects
NASOPHARYNX cancer ,VOLUMETRIC-modulated arc therapy ,PLANNING techniques ,COMPUTED tomography ,LINEAR accelerators - Abstract
Purpose: The current study aims to compare the split x-jaw planning technique of volumetric modulated arc radiotherapy (VMAT) with the traditional open and limited jaw techniques of VAMT in nasopharyngeal carcinoma treatment. The multi-leaf collimators on the varian linear accelerator move on a carriage with a maximum leaf span of 15 cm. Therefore, treatment of larger planning target volumes, such as in nasopharyngeal cancer with traditional open and limited jaw technique, yields compromised dose distribution. Method: Computed tomography data sets of 10 nasopharynx cancer patients were enrolled for the study. For each case, three separate treatment plans were generated viz. open, limited, and split x-jaw planning techniques with similar planning objectives. Only PTVs requiring a field size larger than 18 cm in the x-jaw position were considered. Results: Comparable results were obtained regarding organs at risk (OAR) sparing in all the techniques. The target dose coverage with split x-jaw VMAT was superior to both open and limited jaw planning techniques, with a statistically significant difference in the intermediate dose planning target volumes (PTVs) (PTV59.4), P < 0.05. However, the split technique’s dose to the spinal cord and larynx was significantly lower (P < 0.05). Conclusion: The split x-jaw planning technique of VMAT can be adapted for larger PTVs requiring an x-jaw of more than 15 cm. The only concern with this technique is the increased MU. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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