1. Dosimetric advantage of volumetric modulated arc therapy in the treatment of intraocular cancer
- Author
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Xiance Jin, Zhenxiang Deng, Jinling Yi, Congying Xie, Ce Han, Lanxiao Shen, Xiaomin Zheng, and Yongqiang Zhou
- Subjects
Male ,Organs at Risk ,Oncology ,genetic structures ,medicine.medical_treatment ,Planning target volume ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Aged, 80 and over ,Low dose ,Radiotherapy Dosage ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,Intraocular cancer ,030220 oncology & carcinogenesis ,Female ,therapeutics ,Homogeneity index ,lcsh:Medical physics. Medical radiology. Nuclear medicine ,Adult ,medicine.medical_specialty ,Intensity-modulated radiotherapy ,lcsh:R895-920 ,Conformal radiotherapy ,lcsh:RC254-282 ,03 medical and health sciences ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Aged ,Volumetric-modulated radiotherapy ,business.industry ,Eye Neoplasms ,Radiotherapy Planning, Computer-Assisted ,Research ,Cancer ,medicine.disease ,Volumetric modulated arc therapy ,Radiation therapy ,stomatognathic diseases ,Radiotherapy, Intensity-Modulated ,Nuclear medicine ,business ,Follow-Up Studies - Abstract
Objective The purpose of this study is to investigate the dosimetric advantages of volumetric modulated arc therapy (VMAT) in the treatment of intraocular cancer by comparing it directly with three-dimensional conformal radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT). Methods CRT plan, 7f-IMRT plan, and one-arc VMAT plan were generated for 14 intraocular cancer patients. Dosimetric and biological quality indices for target volume and organs at risks (OARs) were evaluated and compared. Results The target coverage presented by V95 for CRT, IMRT and VMAT were 95.02% ± 0.67%, 95.51% ± 2.25%, and 95.92% ± 3.05%, respectively. The homogeneity index (HI) for CRT, IMRT and VMAT were 0.15 ± 0.05, 0.23 ± 0.05, and 0.23 ± 0.06, respectively. IMRT and VMAT greatly decreased the dose to ipsilateral lens compared with CRT with a D1 of 2972.66 ± 1407.12 cGy, 3317.82 ± 915.28 cGy and 4809.54 ± 524.60 cGy for IMRT, VMAT and CRT, respectively. Similar results were observed for ipsilateral eyeballs. IMRT and VMAT also spared better on brainstem, optical nerves and optical chiasm compared CRT. However, CRT achieved lower dose to the eyeballs compared with IMRT and VMAT. VMAT and IMRT showed mixed results on target coverage and OAR sparing. The average MUs and delivery time of IMRT and VMAT were 531.25 ± 81.21 vs. 400.99 ± 61.49 and 5.05 ± 0.53 vs.1.71 ± 0.69 min, respectively. Conclusions Although no clear distinction on PTV coverage among CRT, IMRT and VMAT plans was observed in the treatment of intraocular cancer, VMAT and IMRT achieved better homogeneity and conformity for target volume, and delivered fewer doses to ipsilateral lens and eyeballs compared with CRT. However, VMAT and IMRT increased the low dose volume to the contralateral OARs. Although VMAT and IMRT showed mixed results on target coverage and OAR sparing, VMAT decreased MU and delivery time significantly compared with IMRT. VMAT is a promising and feasible external beam radiotherapy technique in the treatment of intraocular cancer patients.
- Published
- 2017