Progress in Medical Physics (한국의학물리학회지:의학물리)

Korean Society of Medical Physics (한국의학물리학회)
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Dosimetric Evaluation of Low-Dose Spillage Volumes for Head and Neck Cancer Using Intensity-Modulated Radiation Therapy and Volumetric Modulated Arc Therapy Treatment Techniques

  • Kumar, Gourav (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre) ;
  • Bhushan, Manindra (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre) ;
  • Kumar, Lalit (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre) ;
  • Kishore, Vimal (Department of Applied Science & Humanities, Bundelkhand Institute of Engineering & Technology) ;
  • Raman, Kothanda (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre) ;
  • Kumar, Pawan (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre) ;
  • Barik, Soumitra (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre) ;
  • Purohit, Sandeep (Medical Physics Division & Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre)
  • Received : 2021.06.05
  • Accepted : 2021.08.10
  • Published : 2021.09.30
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Abstract

Purpose: This study was designed to investigate the dosimetric difference between intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in head and neck cancer (HNC). The study primarily focuses on low-dose spillage evaluation between these two techniques. Methods: This retrospective study involved 45 patients with HNC. The treatment plans were generated using the IMRT and VMAT techniques for all patients. Dosimetric comparisons were performed in terms of target coverage, organ-at-risk (OAR) sparing, and various parameters, including conformity index, uniformity index, homogeneity index, conformation number, low-dose volumes, and normal tissue integral dose (NTID). Results: No significant (P>0.05) difference in planning target volume coverage (D95%) was observed between IMRT and VMAT plans for supraglottic larynx, hard palate, and tongue cancers. A decrease in dose volumes ranging from 1 Gy to 30 Gy was observed for VMAT plans compared with those for IMRT plans, except for V1Gy and V30Gy for supraglottic larynx cancer and V1Gy for tongue cancer. Moreover, decreases (P<0.05) in NTID were observed for VMAT plans compared with that for IMRT plans in supraglottic larynx (4.50%), hard palate (12.80%), and tongue (7.76%) cancers. In contrast, a slight increase in monitor units for VMAT compared with those for IMRT in supraglottic larynx (0.46%), hard palate (2.54%), and tongue (7.56%) cancers. Conclusions: For advanced-stage HNC, both IMRT and VMAT offer satisfactory clinical plans. VMAT offers a conformal and homogeneous dose distribution with comparable OAR sparing and higher dose falloff outside the target volume than IMRT, which provides an edge to reduce the risk of secondary malignancies for HNC over IMRT.

Keywords

Acknowledgement

The authors thank the management of Rajiv Gandhi Cancer Institute & Research Centre in New Delhi, India, for their continued support and encouragement to complete this research work.

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