Abstract
Purpose: To compare (3D-CRT) to RapidArc planning using (LNAC of 6 MV) in terms of dosimetric outcomes of iso-dose distribution, dose volume histogram (DVH), PTV and at risk organs in 5 patients with Esophageal cancer (EC). Methods: Plans were created for 5 patients with EC who had received radical RapidArc treatment from 2012 to 2014 at KAMC (King Abdullah Medical City). Results: RapidArc plan showed a more homogeneous dose distribution in PTV, achieving an HI of 1.112 ± 0.030 compared with 1.096 ± 0.029 in the 3D-CRT plan. However, RapidArc and 3D-CRT achieved nearly equal in both modalities with average value of (0.130 ± 0.052) in RapidArc compared to (0.134 ± 0.054) in 3D-CRT, (p = 0.061) in terms of CI values and Target coverage index (TCI) was (0.093 ± 0.032) in RapidArcand and (0.099 ±0.058) in 3D-CRT, (p = 0.767). Additionally, regarding OARs, the mean and maximum dose in Spinal Cord was lower in RapidArc with a low percentage of the volume receiving low doses. Left and Right Lungs were within tolerance in RapidArc and 3D-CRT. RT. Kidney was lower in RapidArc, while LT Kidney was lower in 3D-CRT. For Heart, the maximum dose was within tolerance criteria in RapidArc but exceeded the criteria in 3D-CRT at 60.97 Gy. For the spinal cord, the maximum dose was notably low and did not exceed 1.91 Gy in RapidArc, while it exceeded the acceptable limit in 3D-CRT. Conclusions: (VMAT) is superior to 3D-CRT in term of PTV, conformity and homogeneity. This study suggests that VMAT class solution is the superior treatment option.
Highlights
The center leaf width is 5 mm projected at isocenter, while the outer leaves are larger at 10 mm
Differences were recorded between those patients who planned with 3D conformal radiotherapy (3D-CRT) and those who planned with
One patient was selected to represent all other patients in this site for isodose distribution comparison, dose volume histogram (DVH) comparison, dosimetric results for the planning target volume (PTV) and dosimetric results for the critical organs
Summary
Radiation oncology includes the clinical and scientific discipline devoted to management of patients with cancer (and other diseases) with ionizing radiation (alone or combined with other modalities), investigation of the biologic and physical basis of radiation therapy, and training of professionals in the field. The aim of radiation therapy is to deliver a precisely measured dose of irradiation to a defined tumor volume with minimal damage to surrounding healthy tissue. This results in eradication of the tumor, increased quality of life, and prolongation of survival at a competitive cost, and allows for effective palliation or prevention of symptoms of cancer, including pain, restoring luminal patency, skeletal integrity, and organ function, with minimal morbidity [1, 2]
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