COMPARISON BETWEEN INTENSITY-MODULATED RADIOTHERAPY (IMRT) AND VOLUMETRIC MODULATED ARC THERAPY (VMAT) IN THE TREATMENT OF LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER
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Keywords
Chemoradiation, IMRT, lung, response, VMAT
Abstract
Background: For stage III non-small cell lung cancer (NSCLC), current treatment is conventional radiotherapy, concurrently with platinum chemotherapy with or without induction chemotherapy, with consolidation durvalumab. Volumetric modulated arc therapy (VMAT) allows higher target conformity and homogeneity with less scatter dose due to reducing MU, causing fewer secondary malignancies and less treatment time.
Aim: Comparison between IMRT and VMAT in stage III NSCLC patients regarding dosimetric differences and clinical outcome including response, survival and toxicity and their correlation with clinicopathological characteristics.
Methods: This is a prospective randomized study using simple randomization by coin which included 60 patients with stage III NSCLC who received concurrent chemoradiation at Clinical Oncology and Nuclear Medicine Department Tanta University Hospitals comparing clinical outcome and correlation with clinicopathological characteristics and dosimetric parameters throughout the period from July 2021 to June 2023. Thirty patients received IMRT (Group A) and 30 received VMAT (Group B).
Results: There was no significant difference in dosimetric parameters except for contralateral mean dose and esophageal parameters without effect on toxicity. The main significant difference was shorter delivery time and less monitor units in VMAT group. There was no significant difference in response. Progression free survival was significantly higher in VMAT with significant correlation to grade and mean esophageal dose.
Conclusion: The VMAT provides shorter delivery time and less monitor units with less treatment cost. Both IMRT and VMAT are similar in toxicity. Progression free survival is higher in VMAT with similar treatment response.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Rana Saeed El-Sayed Ata
Assistant lecturer of Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Tanta university
Omnia Abd El Fattah Gad
Professor of Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Tanta University
Medhat Mohamed El Sebaie
Professor of Clinical Radiation Oncology and Nuclear Medicine, National Cancer Institute, Cairo University
Asmaa Mohamed El-Kady
Associate Professor of Clinical Oncology & Nuclear Medicine, Faculty of Medicine, Tanta University