A dosimetric and treatment efficiency evaluation of stereotactic body radiation therapy for peripheral lung cancer using flattening filter free beams.

Ji-Yong Zhang,Jia-Yang Lu,Li-Li Wu,Chang-Chun Ma,Zhi-Xiong Lin,Dan-Li Hong,Xun Peng

doi:10.18632/oncotarget.12071

Abstract

To investigate potential dosimetric benefits and treatment efficiency of dynamic conformal arc therapy (DCA), intensity modulated radiation therapy (IMRT), and double partial arcs Rapidarc (RA) techniques in the treatment of early-stage peripheral lung cancer using stereotactic body radiotherapy (SBRT) with flattening filter free (FFF) beams. Twenty early-stage peripheral lung cancer patients were selected. For each patient, DCA, IMRT and RA plans were created to meet Radiation Therapy Oncology Group (RTOG) 0915 objectives with 48 Gy covering 95% of the planning target volume (PTV) in 4 fractions. PTV coverage, organs at risk (OARs) doses, planning time, monitor units (MU) and treatment time were evaluated. RA was significantly better than DCA for PTV coverage. RA provided a lower V32Gy to chest wall and less V20Gy to lung over those of DCA and IMRT. For other OARs, there is no significant difference among all three techniques. DCA plans showed significantly less planning time, shorter treatment time and lower MU number than those of RA and IMRT. RA provides a superior dosimetric benefit to DCA and IMRT in the treatment of early-stage lung cancer using SBRT with FFF beams. Considering the MU number, planning time and treatment efficiency, DCA technique is an effective treatment strategy.

Highlights

Lung cancer is the major reason of cancer death among males [1]
Lung cancer is the primary cause of cancer death in more developed countries, and the lung cancer incidence rates in Chinese women are 204 cases per one million [1]
Between dynamic conformal arc therapy (DCA) and intensity modulated radiation therapy (IMRT), no statistical difference was observed in terms of D98%, D50%, D2%, V90%, V95% and V105%

Summary

Introduction

Lung cancer is the major reason of cancer death among males [1]. Lung cancer is the primary cause of cancer death in more developed countries, and the lung cancer incidence rates in Chinese women are 204 cases per one million [1]. Non-small-cell lung cancer (NSCLC) takes up more than 85% of all lung cancer [2]. For early-stage NSCLC patient, surgery is still the considerable choice in the treatment [3, 4]. Not all early-stage NSCLC patients are suited for surgery because of advanced age, or patients refusing surgical treatment. Stereotactic body radiotherapy (SBRT) is an alternative method for these patients

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