Dosimetric comparison of three-dimensional conformal radiotherapy and static and dynamic intensity-modulated radiotherap
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ORIGINAL RESEARCH
Dosimetric comparison of three-dimensional conformal radiotherapy and static and dynamic intensity-modulated radiotherapy for the treatment of early-stage glottic cancer Gokcen Inan 1
&
Osman Vefa Gul 1
Received: 4 May 2020 / Accepted: 13 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background The aim of this study was to compare dosimetric variations using the three-dimensional conformal radiotherapy (3DCRT), dynamic intensity-modulated radiation therapy (D-IMRT), and static intensity-modulated radiation therapy (S-IMRT) techniques for glottic cancer. Materials and methods Ten patients with early-stage glottic cancer were retrospectively selected and evaluated. The 3DCRT and IMRT treatment plans were performed using the solution commercialized by Varian with the Eclipse treatment planning system (TPS). For each patient, five different treatment plans were created and compared with respect to the doses received by the organs at risk (OARs) including the carotid arteries, thyroid gland, and spinal cord; the dose homogeneity index (DHI); conformity indexes (CI); and total monitor unit (MU) counts required for the treatment. The Mann-Whitney U test was used for statistical analyses. Results Statistically significant differences for the 3DCRT, D-IMRT, and S-IMRT techniques were observed for the planning target volume (PTV) mean and maximum doses. The results of this study indicated an increase in DHI for 3DCRT compared with D-IMRT and S-IMRT. Furthermore, the S-IMRT technique led to the superior decreased dose to the OAR. The 3DCRT plans performed better at the Dmax of the spinal cord and MU counts. Conclusion The D-IMRT and S-IMRT techniques allowed more homogeneous dose distributions in PTV. Considering the dose to OAR, S-IMRT was more appropriate rather than 3DCRT and D-IMRT. Keywords Glottic cancer . Dynamic intensity-modulated radiation therapy . Static intensity-modulated radiation therapy
Introduction The aim of radiotherapy treatment planning is to provide the best dose conformation to the target volume, while sparing critical organs and healthy tissues [1, 2]. Intensity-modulated radiation therapy (IMRT) is known as a powerful device to the quality of the delivered dose distribution in head and neck cancer [3, 4]. Several critical organs in the brain and head and neck regions are usually in close proximity to the tumor. This problem makes radiation therapy for these types of cancers a very challenging treatment [5, 6]. IMRT has the
* Gokcen Inan [email protected] 1
Department of Radiation Oncology Medicine Faculty, Selcuk University, Konya, Turkey
capability of producing highly conformal dose distributions with steep dose gradients to target areas of concern while sparing nearby critical organs in the neck [1, 7]. For a given gantry angle, a computer-controlled multileaf collimator (MLC) is not only useful in shaping beam apertures for conventional radiotherapy but also programmed to deliver IMRT. This has been done in two different ways [
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