Progress in Medical Physics (한국의학물리학회지:의학물리)

Korean Society of Medical Physics (한국의학물리학회)
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Dosimetric Comparison of Three-Dimensional Conformal, Intensity-Modulated Radiotherapy, Volumetric Modulated Arc Therapy, and Dynamic Conformal Arc Therapy Techniques in Prophylactic Cranial Irradiation

  • Ismail Faruk Durmus (Department of Radiation Oncology, Istanbul Yeni Yuzyil University Gaziosmanpasa Hospital) ;
  • Dursun Esitmez (Department of Radiation Oncology, Vocational School of Health Services, Istanbul Medipol University) ;
  • Guner Ipek Arslan (Department of Radiation Oncology, Istanbul Yeni Yuzyil University Gaziosmanpasa Hospital) ;
  • Ayse Okumus (Department of Radiation Oncology, Istanbul Yeni Yuzyil University Gaziosmanpasa Hospital)
  • Received : 2023.08.09
  • Accepted : 2023.09.22
  • Published : 2023.12.31
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Abstract

Purpose: This study aimed to dosimetrically compare the technique of three-dimensional conformal radiotherapy (3D CRT), which is a traditional prophylactic cranial irradiation method, and the intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques used in the last few decades with the dynamic conformal arc therapy (DCAT) technique. Methods: The 3D CRT, VMAT, IMRT, and DCAT plans were prepared with 25 Gy in 10 fractions in a Monaco planning system. The target volume and the critical organ doses were compared. A comparison of the body V2, V5, and V10 doses, monitor unit (MU), and beam on-time values was also performed. Results: In planned target volume of the brain (PTVBrain), the highest D99 dose value (P<0.001) and the most homogeneous (P=0.049) dose distribution according to the heterogeneity index were obtained using the VMAT technique. In contrast, the lowest values were obtained using the 3D CRT technique in the body V2, V5, and V10 doses. The MU values were the lowest when DCAT (P=0.001) was used. These values were 0.34% (P=0.256) lower with the 3D CRT technique, 66% (P=0.001) lower with IMRT, and 72% (P=0.001) lower with VMAT. The beam on-time values were the lowest with the 3D CRT planning (P<0.001), 3.8% (P=0.008) lower than DCAT, 65% (P=0.001) lower than VMAT planning, and 76% (P=0.001) lower than IMRT planning. Conclusions: Without sacrificing the homogeneous dose distribution and the critical organ doses in IMRTs, three to four times less treatment time, less low-dose volume, less leakage radiation, and less radiation scattering could be achieved when the DCAT technique is used similar to conventional methods. In short, DCAT, which is applicable in small target volumes, can also be successfully planned in large target volumes, such as the whole-brain.

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References

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