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The Dosimetric Performance of Volumetric Modulated Arc Therapy and Intensity Modulated Radiation Therapy in the Treatment of Locally Advanced Laryngeal Cancer

Document Type : Original Article(s)

Authors

1 Biophysics Department, Faculty of Science, Cairo University, Giza, Egypt

2 Radiotherapy Department, Augusta Victoria Hospital, Jerusalem, Palestine

3 National Cancer Institute, Cairo University, Giza, Egypt

4 Physics Department, Faculty of Science, the Islamic University of Madinah, Madinah, KSA

Abstract

Background: This study aims to compare the performance of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in treating laryngeal cancer.
Method: In this retrospective dosimetric study, 15 patients diagnosed with locally advanced laryngeal cancer (LALC) were selected. The dosimetric performance of the two techniques was analyzed using 6 MV X-rays, based on dose-volume histograms for primary and boost planning target volumes (PTVp and PTVb, respectively), relevant organs at risk (OARs), mean Dose (Dmean), maximum Dose (Dmax), 95% Dose (D95), 2% Dose (D2%), 5% Dose (D5%), monitor units per segment (MU/segment), number of MU/cGy, treatment delivery time, along with conformity and homogeneity indices.
Results: Both techniques were able to achieve favorable equivalent uniform doses and low doses to OARs. The average total number of monitor units for IMRT was significantly greater than that for VMAT (1724.5 ± 249.5 and 475.3 ± 47.0, respectively for PTVp and 601.4 ± 81.7 and 458.0 ± 62.6, respectively for PTVb). The modulation factor (MU/cGy) of IMRT was significantly greater than that for VMAT for both the primary and the boost phases. The mean treatment delivery time for all cases of IMRT was significantly longer than that of VMAT.
Conclusion: The primary distinction between IMRT and VMAT in the treatment of LALC is that VMAT requires significantly fewer monitor units (one-third) compared with IMRT. This reduction contributes to a decrease in treatment time, which in turn positively impacts patient comfort and the accuracy of treatment.

Keywords

How to cite this article:

Khater F, Attalla E, Elshemey W, Mohammed H. The dosimetric performance of volumetric modulated arc therapy and intensity modulated radiation therapy in the treatment of locally advanced laryngeal cancer. Middle East J Cancer. 2024;15(1):25-39. doi: 10. 30476/mejc.2023.95920.1798.

References
  1. Pai SI, Westra WH. Molecular pathology of head and neck cancer: implications for diagnosis, prognosis, and treatment. Annu Rev Pathol. 2009;4:49-70. doi: 10.1146/annurev.pathol.4.110807.092158.
  2. Ciolofan MS, Vlăescu AN, Mogoantă CA, Ioniță E, Ioniță I, Căpitănescu AN, et al. Clinical, histological and immunohistochemical evaluation of larynx cancer. Curr Health Sci J. 2017;43(4):367-75. doi: 10.12865/CHSJ.43.04.14.
  3. Bertelsen A, Hansen CR, Johansen J, Brink C. Single arc volumetric modulated arc therapy of head and neck cancer. Radiother Oncol. 2010;95(2):142-8. doi: 10.1016/j.radonc.2010.01.011.
  4. Peeters ST, Heemsbergen WD, Koper PC, Van Putten WL, Slot A, Dielwart MF, et al. Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy. J Clin Oncol. 2006;24(13):1990-6. doi: 10.1200/JCO.2005.05.2530.
  5. Huang YS, Lee CC, Chang TS, Ho HC, Su YC, Hung SK, et al. Increased risk of stroke in young head and neck cancer patients treated with radiotherapy or chemotherapy. Oral Oncol. 2011;47(11):1092-7. doi: 10.1016/j.oraloncology.2011.07.024.
  6. Chera BS, Amdur RJ, Morris CG, Mendenhall WM. Carotid-sparing intensity-modulated radiotherapy for early-stage squamous cell carcinoma of the true vocal cord. Int J Radiat Oncol Biol Phys. 2010;77(5):1380-5. doi: 10.1016/j.ijrobp.2009.07.1687.
  7. Hall EJ, Wuu CS. Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys. 2003;56(1):83-8. doi: 10.1016/s0360-3016(03)00073-7.
  8. Kry SF, Salehpour M, Followill DS, Stovall M, Kuban DA, White RA, et al. The calculated risk of fatal secondary malignancies from intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2005;62(4):1195-203. doi: 10.1016/j.ijrobp.2005.03.053.
  9. DiBartolo D, Carpenter TJ, Santoro JP, Ebling DW, Haas JA, Lischalk JW, et al. Novel VMAT planning technique improves dosimetry for head and neck cancer patients undergoing definitive chemoradiotherapy. Int J Radiat Oncol Biol Phys.2022;112(5):e33. doi: 1016/j.ijrobp.2021.12.077.
  10. Amendola BE, Amendola M, Perez N, Iglesias A, Wu X. Volumetric-modulated arc therapy with RapidArc(®): An evaluation of treatment delivery efficiency. Rep Pract Oncol Radiother. 2013;18(6):383-6. doi: 10.1016/j.rpor.2013.07.005.
  11. Abbas AS, Moseley D, Kassam Z, Kim SM, Cho C. Volumetric-modulated arc therapy for the treatment of a large planning target volume in thoracic esophageal cancer. J Appl Clin Med Phys. 2013;14(3):4269. doi: 10.1120/jacmp.v14i3.4269.
  12. Didona A, Lancellotta V, Zucchetti C, Panizza BM, Frattegiani A, Iacco M, et al. Is volumetric modulated arc therapy with constant dose rate a valid option in radiation therapy for head and neck cancer patients? Rep Pract Oncol Radiother. 2018;23(3):175-82. doi: 10.1016/j.rpor.2018.02.007.
  13. Osborn J. Is VMAT beneficial for patients undergoing radiotherapy to the head and neck? Radiography (Lond). 2017;23(1):73-6. doi: 10.1016/j.radi.2016.08.008.
  14. Verbakel WF, Cuijpers JP, Hoffmans D, Bieker M, Slotman BJ, Senan S. Volumetric intensity-modulated arc therapy vs. conventional IMRT in head-and-neck cancer: a comparative planning and dosimetric study. Int J Radiat Oncol Biol Phys. 2009;74(1):252-9. doi: 10.1016/j.ijrobp.2008.12.033.
  15. Fung-Kee-Fung SD, Hackett R, Hales L, Warren G, Singh AK. A prospective trial of volumetric intensity-modulated arc therapy vs conventional intensity modulated radiation therapy in advanced head and neck cancer. World J Clin Oncol. 2012;3(4):57-62. doi: 10.5306/wjco.v3.i4.57.
  16. Johnston M, Clifford S, Bromley R, Back M, Oliver L, Eade T. Volumetric-modulated arc therapy in head and neck radiotherapy: a planning comparison using simultaneous integrated boost for nasopharynx and oropharynx carcinoma. Clin Oncol (R Coll Radiol). 2011;23(8):503-11. doi: 10.1016/j.clon.2011.02.002.
  17. Vanetti E, Clivio A, Nicolini G, Fogliata A, Ghosh-Laskar S, Agarwal JP, et al. Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT. Radiother Oncol. 2009;92(1):111-7. doi: 10.1016/j.radonc.2008.12.008.
  18. Buciuman N, Marcu LG. Is there a dosimetric advantage of volumetric modulated arc therapy over intensity modulated radiotherapy in head and neck cancer? Eur Arch Otorhinolaryngol. 2022;279(11):5311-21. doi: 10.1007/s00405-022-07452-1.
  19. Caudell JJ, Gillison ML, Maghami E, Spencer S, Pfister DG, Adkins D, et al. NCCN Guidelines® insights: head and neck cancers, version 1.2022. J Natl Compr Canc Netw. 2022;20(3):224-34. doi: 10.6004/jnccn.2022.0016.
  20. Das IJ, Andersen A, Chen ZJ, Dimofte A, Glatstein E, Hoisak J, et al. State of dose prescription and compliance to international standard (ICRU-83) in intensity modulated radiation therapy among academic institutions. Pract Radiat Oncol. 2017;7(2):e145-e155. doi: 10.1016/j.prro.2016.11.003.
  21. Jones D. The Internationsl Journal of Medical Physics Research and Practice: American Association of Physicists in Medicine. ICRU report 50—prescribing, recording and reporting photon beam therapy; June 1994. doi: 1118/1.597396.
  22. Aleman BM, Bartelink H, Gunderson LL. The current role of radiotherapy in colorectal cancer. Eur J Cancer. 1995;31A(7-8):1333-9. doi: 10.1016/0959-8049(95)00280-v.
  23. Drzymala RE, Mohan R, Brewster L, Chu J, Goitein M, Harms W, et al. Dose-volume histograms. Int J Radiat Oncol Biol Phys. 1991;21(1):71-8. doi: 10.1016/0360-3016(91)90168-4.
  24. Shaw E, Kline R, Gillin M, Souhami L, Hirschfeld A, Dinapoli R, et al. Radiation Therapy Oncology Group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys. 1993;27(5):1231-9. doi: 10.1016/0360-3016(93)90548-a.
  25. Feuvret L, Noël G, Mazeron JJ, Bey P. Conformity index: a review. Int J Radiat Oncol Biol Phys. 2006;64(2):333-42. doi: 10.1016/j.ijrobp.2005.09.028.
  26. Gong Y, Wang J, Bai S, Jiang X, Xu F. Conventionally-fractionated image-guided intensity modulated radiotherapy (IG-IMRT): a safe and effective treatment for cancer spinal metastasis. Radiat Oncol. 2008;3:11. doi: 10.1186/1748-717X-3-11.
  27. Wu Q, Mohan R, Morris M, Lauve A, Schmidt-Ullrich R. Simultaneous integrated boost intensity-modulated radiotherapy for locally advanced head-and-neck squamous cell carcinomas. I: dosimetric results. Int J Radiat Oncol Biol Phys. 2003;56(2):573-85. doi: 10.1016/s0360-3016(02)04617-5.
  28. Kataria T, Sharma K, Subramani V, Karrthick KP, Bisht SS. Homogeneity Index: An objective tool for assessment of conformal radiation treatments. J Med Phys. 2012;37(4):207-13. doi: 10.4103/0971-6203.103606.
  29. Paddick I. A simple scoring ratio to index the conformity of radiosurgical treatment plans. Technical note. J Neurosurg. 2000;93 Suppl 3:219-22. doi: 10.3171/jns.2000.93.supplement.
  30. Ben-David MA, Diamante M, Radawski JD, Vineberg KA, Stroup C, Murdoch-Kinch CA, et al. Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. Int J Radiat Oncol Biol Phys. 2007;68(2):396-402. doi: 10.1016/j.ijrobp.2006.11.059.
  31. Gomez DR, Zelefsky MJ, Wolden SL, Estilo CL, Fury MG, Pfister DG, et al. Osteoradionecrosis (ORN) of the mandible in head/neck cancer treated with intensity modulated radiation therapy (IMRT). Int J Radiat Oncol Biol Phys. 2008;72(1):S410. doi: 1016/j.ijrobp.2008.06.1306.
  32. Blanco AI, Chao KS, El Naqa I, Franklin GE, Zakarian K, Vicic M, et al. Dose-volume modeling of salivary function in patients with head-and-neck cancer receiving radiotherapy. Int J Radiat Oncol Biol Phys. 2005;62(4):1055-69. doi: 10.1016/j.ijrobp.2004.12.076.
  33. Deasy JO, Moiseenko V, Marks L, Chao KS, Nam J, Eisbruch A. Radiotherapy dose-volume effects on salivary gland function. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S58-63. doi: 10.1016/j.ijrobp.2009.06.090.
  34. Kirkpatrick JP, van der Kogel AJ, Schultheiss TE. Radiation dose-volume effects in the spinal cord. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S42-9. doi: 10.1016/j.ijrobp.2009.04.095.
  35. Emami B. Tolerance of normal tissue to therapeutic radiation. Rep Radiother Oncol. 2013;1(1):123-7.
  36. Wang JZ, Li XA, D'Souza WD, Stewart RD. Impact of prolonged fraction delivery times on tumor control: a note of caution for intensity-modulated radiation therapy (IMRT). Int J Radiat Oncol Biol Phys. 2003;57(2):543-52. doi: 10.1016/s0360-3016(03)00499-1.
  37. Longobardi B, De Martin E, Fiorino C, Dell'oca I, Broggi S, Cattaneo GM, et al. Comparing 3DCRT and inversely optimized IMRT planning for head and neck cancer: equivalence between step-and-shoot and sliding window techniques. Radiother Oncol. 2005;77(2):148-56. doi: 10.1016/j.radonc.2005.09.011.
  38. Pursley J, Damato AL, Czerminska MA, Margalit DN, Sher DJ, Tishler RB. A comparative study of standard intensity-modulated radiotherapy and RapidArc planning techniques for ipsilateral and bilateral head and neck irradiation. Med Dosim. 2017;42(1):31-6. doi: 10.1016/j.meddos.2016.10.004.
  39. Rao M, Yang W, Chen F, Sheng K, Ye J, Mehta V, et al. Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: plan quality, delivery efficiency and accuracy. Med Phys. 2010;37(3):1350-9. doi: 10.1118/1.3326965.

 

Middle East Journal of Cancer
Volume 15, Issue 1 - Serial Number 57
January 2024
Pages 25-39
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