Abstract

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Title:: Application of non-coplanar volumetric modulated arc therapy for esophageal cancer

Author(s):: SHEN Jiuling1; LIU Hui1; LIAO Zhengkai1; YU Haijun1; CHEN Cheng1; ZHANG Jun1; HU Zhi2; ZHANG Ang2; WANG Wei2; XIE Conghua1; 1. Department of Radio-chemotherapy, Zhongnan Hospital, Wuhan University, Wuhan 430072, China; 2. Yingshan People’s Hospital, Huanggang 438700, China

Keywords:: Keywords: esophageal cancer; non-coplanar volumetric modulated arc therapy; dosimetry

Abstract:: Abstract: Objective To investigative the application prospect of non-coplanar volumetric modulated arc therapy (VMAT) in treatment for esophageal cancer. Methods Fifteen patients with locally advanced thoracic esophageal cancer who were admitted from September to December 2017 were enrolled in this study. Coplanar intensity-modulated radiotherapy (IMRT), non-coplanar IMRT and non-coplanar VMAT plans were designed for each patient. The dose distributions of target areas and organs-at-risk between non-coplanar VMAT and coplanar IMRT or non-coplanar IMRT were analyzed. Results All the 3 plans met the requirements of target dose coverage, but non-coplanar VMAT had significant advantages over non-coplanar IMRT in homogeneity index and conformity index (P<0.05). The Dmax of spinal cord of non-coplanar VMAT was significantly lower than that of coplanar IMRT and non-coplanar IMRT (P<0.05); and non-coplanar VMAT was superior to coplanar IMRT in the V5, V20, V30 and Dmean of the lung (P<0.05). No statistical difference was found in the V30 and V40 of the heart between non-coplanar VMAT and IMRT. Conclusion For patients with esophageal cancer, non-coplanar VMAT can improve the conformity index and homogeneity index of target areas and reduce the dose and irradiated volume of the lung and spinal cord, thereby reducing the probabilities of radiation pneumonitis and radioactive spinal cord.