A dosimetric comparison of volumetric modulated arc therapy with three-dimensional conformal radiotherapy in the treatment of cervical cancer

SA Journal of Oncology

Field Value
Title A dosimetric comparison of volumetric modulated arc therapy with three-dimensional conformal radiotherapy in the treatment of cervical cancer
Creator Bhagaloo, Visham Bhim, Nazreen Hunter, Alistair Fakie, Nazia
Subject Radiation Oncology; Gynaecology; Dosimetry cervical cancer; VMAT; 3D-CRT; radiation therapy; dosimetry
Description Background: External beam radiotherapy (EBRT) is essential in the management of locally advanced cervical cancer (LACC). Volumetric modulated arc therapy (VMAT) is thought to achieve higher conformity to the planned target volume (PTV) and better sparing of organs at risk (OAR) when compared to three-dimensional conformal radiotherapy (3D-CRT). This study focused on these principles as it applied to treatment and potential toxicity in the management of LACC.Aim: The aim of this study was to compare dosimetric parameters between VMAT and 3D-CRT in the management of LACC.Setting: The study analysed patients treated at Groote Schuur Hospital (GSH) between May and December 2017.Methods: This is a non-randomised comparative retrospective study. Three-dimensional conformal radiation and VMAT plans were generated, and data on treatment parameters for PTV D50%, Dmax, Dmean, conformity index (CI), homogeneity index (HI), treated volume (TV), irradiated volume (IV) and OAR constraints; femoral heads, bladder, bowel bag, rectum and bone marrow were collected.Results: Of the 45 patients assessed, VMAT showed statistically significant, lower treatment parameter values for CI (1.09 vs. 1.49) and TV (1613.1 cm3 vs. 2230.3 cm3), whereas 3D-CRT showed lower Dmax (48.1 Gy vs. 49.2 Gy) and IV (10652.2 cm3 vs. 14618.1 cm3). Volumetric modulated arc therapy OAR doses revealed a lower V45 for bowel bag (182.3 cm3 vs. 411.3 cm3; p 0.001), lower V40 for bone marrow (19.1% vs. 38.7%; p 0.001) and rectum (88.5% vs. 96%; p 0.001). A reduced 3D-CRT dose was noted for bladder Dmax (47.4 Gy vs. 48.3 Gy; p 0.001).Conclusion: Volumetric modulated arc therapy offered a superior dosimetric option, with better OAR dose sparing and optimal tumour dosimetry.
Publisher AOSIS
Contributor Prof. Jeannette Parkes and the Radiation Department at GSH. Radiation Therapy Technologists
Date 2021-01-22
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — A non-randomized comparative retrospective study
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajo.v5i0.149
Source South African Journal of Oncology; Vol 5 (2021); 8 pages 2523-0646 2518-8704
Language eng
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https://sajo.org.za/index.php/sajo/article/view/149/434 https://sajo.org.za/index.php/sajo/article/view/149/433 https://sajo.org.za/index.php/sajo/article/view/149/435 https://sajo.org.za/index.php/sajo/article/view/149/432
Coverage South Africa; Western Cape May 2017 to December 2017 Radiotherapy Option; stage, age
Rights Copyright (c) 2021 Visham Bhagaloo, Nazreen Bhim, Alistair Hunter, Nazia Fakie https://creativecommons.org/licenses/by/4.0