JIANG Fan,WU Hao,GONG Jian,HAN Shu-kui.Dosimetric comparison of volumetric modulated Arc therapy with conventional intensity-modulated radiotherapy for preoperative radiotherapy of rectal cancer[J].Chinese Journal of Radiological Medicine and Protection,2011,31(3):322-325
Dosimetric comparison of volumetric modulated Arc therapy with conventional intensity-modulated radiotherapy for preoperative radiotherapy of rectal cancer
Received:April 02, 2010  
DOI:10.3760/cma.j.issn.0254-5098.2011.03.018
KeyWords:RapidArc  Dynamic intensity modulated radiation therapy  Rectal cancer  Dosimetry
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Author NameAffiliation
JIANG Fan Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Department of Radiation Oncology, Peking University School of Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China 
WU Hao Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Department of Radiation Oncology, Peking University School of Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China 
GONG Jian Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Department of Radiation Oncology, Peking University School of Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China 
HAN Shu-kui Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Department of Radiation Oncology, Peking University School of Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China 
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Abstract::
      Objective To compare the dosimetric difference between RapidArc and fixed gantry angle dynamic intensity modulated radiotherapy (dIMRT) in developing the pre-operative radiotherapy for rectal cancer patients. Methods Two techniques, RapidArc and dIMRT, were used respectively to develop the synchronous intensity modulated plans for 10 stage Ⅱ and Ⅲ rectal cancer patients at the dose of gross tumor volume (GTV) of 50.6 Gy divided into 22 fractions and planning target volume (PTV) of 41.8 Gy divided into 22 fractions. Both plans satisfied the condition of 95% of PTV covered by 41.8 Gy. The dose-volume histogram data, isodose distribution, monitor units,and treatment time were compared. Results The two kinds of dose volume histogram (DVH) developed by these two techniques were almost the same. The conformal indexes of GTV and PTV by RapidArc were better than those by dIMRT (t=7.643,8.226, P< 0.05), while the homogeneity of target volume by dIMRT was better (t=-10.065,-4.235, P< 0.05). The dose of rectum and small bowel planned by RapidArc was significantly lower than that by dIMRT (t=2.781, P< 0.05). There were no significant differences in the mean doses of bladder and femoral head between these two techniques. The mean monitor units of RapidArc was 475.5, fewer by 48.5% in comparison with that by the dIMRT (924.6). The treatment mean time by RapidArc was 1.2 min, shorter by 79.5% in comparison with that by dIMRT (5.58 min). Conclusions There is no significant dosimetric difference between the two plans of RapidArc and dIMRT. Compared with dIMRT, RapidArc achieves equal target coverage and organs at risk(OAR) sparing while using fewer monitor units and less time during radiotherapy for patient with rectal cancer.
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