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Comparative Study
. 2017 Apr 27;12(1):76.
doi: 10.1186/s13014-017-0812-1.

Dosimetric comparison of helical tomotherapy, VMAT, fixed-field IMRT and 3D-conformal radiotherapy for stage I-II nasal natural killer T-cell lymphoma

Xianfeng Liu  1 , Erliang Huang  2 , Ying Wang  1 , Yanan He  1 , Huanli Luo  1 , Mingsong Zhong  1 , Da Qiu  1 , Chao Li  1 , Han Yang  1 , Guanglei He  1 , Juan Zhou  3 , Fu Jin  4
Affiliations
Comparative Study

Dosimetric comparison of helical tomotherapy, VMAT, fixed-field IMRT and 3D-conformal radiotherapy for stage I-II nasal natural killer T-cell lymphoma

Xianfeng Liu et al. Radiat Oncol. .

Abstract

Background: The aim of this study was to compare radiotherapy plans for Stage I-II nasal natural killer/T-cell lymphoma (NNKTL) using helical tomotherapy (HT), volumetric-modulated arc therapy (VMAT), Fixed-Field intensity-modulated radiotherapy (IMRT), and three-dimensional conformal radiotherapy (3D-CRT).

Methods: Eight patents with Stage I-II NNKTL treated with IMRT were re-planned for HT, VMAT (two full arcs), and 3D-CRT. The quality of target coverage, the exposure of normal tissue and the efficiency of radiation delivery were analyzed.

Results: HT showed significant improvement over IMRT in terms of D98%, cold spot volume and homogeneity index (HI) of planning target volume (PTV). VMAT provided best dose uniformity (p = 0.000) to PTV, while HT had best dose homogeneity among the four radiotherapy techniques (p = 0.000) to PTV. VMAT obviously reduced treatment time (p = 0.010; 0.000) compared to HT and IMRT. Mean dose of left and right optic nerve was significantly reduced by IMRT compared to HT (19.86%, p = 0.000; 21.40%, p = 0.002) and VMAT (8.97%, p = 0.002; 9.35%, p = 0.001), and maximum dose of left lens of VMAT increased over the HT (36.25%, p = 0.043) and IMRT (40.65%, p = 0.001).

Conclusion: The unexpected results show that both HT and VMAT can achieve higher conformal treatment plans while getting worse organs at risk (OARs) sparing than IMRT for patients with Stage I-II NNKTL. VMAT requires the shortest delivery time, and IMRT delivers the lowest dose to most OARs. The results could provide guidance for selecting proper radiation technologies for different cases.

Keywords: Dosimetry; Helical tomotherapy; IMRT; Nasal natural killer/T-cell lymphoma; VMAT.

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Figures

Fig. 1
Fig. 1
The definition of the target volume
Fig. 2
Fig. 2
Example of the dose distribution using HT, VMAT, IMRT and 3D-CRT for the same patient
Fig. 3
Fig. 3
DVH for (a) HT, (b) VMAT, (c) IMRT and (d) 3D-CRTplans for the same patient
See this image and copyright information in PMC

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