Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Evaluation of the hybrid-dynamic conformal arc therapy technique for radiotherapy of lung cancer

  • Kim, Sung Joon (Department of Radiation Oncology, Kyungpook National University Chilgok Hospital) ;
  • Lee, Jeong Won (Department of Radiation Oncology, Kyungpook National University Chilgok Hospital) ;
  • Kang, Min Kyu (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Kim, Jae-Chul (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Lee, Jeong Eun (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Park, Shin-Hyung (Department of Radiation Oncology, Kyungpook National University School of Medicine) ;
  • Kim, Mi Young (Department of Radiation Oncology, Kyungpook National University Hospital) ;
  • Lee, Seoung-Jun (Department of Radiation Oncology, Kyungpook National University Hospital) ;
  • Moon, Soo-Ho (Department of Radiation Oncology, Kyungpook National University Hospital) ;
  • Ko, Byoung-Soo (Department of Radiation Oncology, Kyungpook National University Chilgok Hospital)
  • Received : 2018.03.30
  • Accepted : 2018.08.16
  • Published : 2018.09.30
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Abstract

Purpose: A hybrid-dynamic conformal arc therapy (HDCAT) technique consisting of a single half-rotated dynamic conformal arc beam and static field-in-field beams in two directions was designed and evaluated in terms of dosimetric benefits for radiotherapy of lung cancer. Materials and Methods: This planning study was performed in 20 lung cancer cases treated with the VERO system (BrainLAB AG, Feldkirchen, Germany). Dosimetric parameters of HDCAT plans were compared with those of three-dimensional conformal radiotherapy (3D-CRT) plans in terms of target volume coverage, dose conformity, and sparing of organs at risk. Results: HDCAT showed better dose conformity compared with 3D-CRT (conformity index: 0.74 ± 0.06 vs. 0.62 ± 0.06, p < 0.001). HDCAT significantly reduced the lung volume receiving more than 20 Gy (V20: 21.4% ± 8.2% vs. 24.5% ± 8.8%, p < 0.001; V30: 14.2% ± 6.1% vs. 15.1% ± 6.4%, p = 0.02; V40: 8.8% ± 3.9% vs. 10.3% ± 4.5%, p < 0.001; and V50: 5.7% ± 2.7% vs. 7.1% ± 3.2%, p < 0.001), V40 and V50 of the heart (V40: 5.2 ± 3.9 Gy vs. 7.6 ± 5.5 Gy, p < 0.001; V50: 1.8 ± 1.6 Gy vs. 3.1 ± 2.8 Gy, p = 0.001), and the maximum spinal cord dose (34.8 ± 9.4 Gy vs. 42.5 ± 7.8 Gy, p < 0.001) compared with 3D-CRT. Conclusions: HDCAT could achieve highly conformal target coverage and reduce the doses to critical organs such as the lung, heart, and spinal cord compared to 3D-CRT for the treatment of lung cancer patients.

Keywords

References

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