Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR)
Abstract Introduction Stereotactic ablative radiotherapy (SABR) can be a curative option for non‐small cell lung cancer (NSCLC) and oligometastatic lung disease. Volumetric modulated arc therapy (VMAT) has offered further advancements in terms of radiation dose shaping without compromising treatment...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | Journal of Medical Radiation Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jmrs.634 |
| _version_ | 1811162000741367808 |
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| author | Frances Mark Anoud Alnsour Scott N. Penfold Adrian Esterman Robert Keys Hien Le |
| author_facet | Frances Mark Anoud Alnsour Scott N. Penfold Adrian Esterman Robert Keys Hien Le |
| author_sort | Frances Mark |
| collection | DOAJ |
| description | Abstract Introduction Stereotactic ablative radiotherapy (SABR) can be a curative option for non‐small cell lung cancer (NSCLC) and oligometastatic lung disease. Volumetric modulated arc therapy (VMAT) has offered further advancements in terms of radiation dose shaping without compromising treatment times however there is potential for greater low‐dose exposure to the lung. This study was to assess whether VMAT lung SABR would result in any increase to the dosimetry parameters compared with three‐dimensional conformal radiotherapy (3D‐CRT) that could confer increased risk of radiation pneumonitis. Methods A total of 53 and 30 3D‐CRT treatment plans of patients treated with 48 Gy in 4 fractions were compared. Results No statistically significant difference in planning target volumes between the VMAT 29.9 cc (range 12.4–58.5 cc) and 3D‐CRT 31.2 cc (range 12.3–58.3 cc) P = 0.79. The mean of total lung V5, ipsilateral lung V5 and contralateral lung V5 all showed a trend of being smaller in the VMAT treatment group‐ 14% versus 15.8%, 25.6% versus 30.4% and 1.6% versus 2.2%, respectively, but all were not statistically significant differences. Mean of the mean lung dose MLD, again showed a trend of being lower in the VMAT treatments but was also non‐significant, 2.6 Gy versus 3.0 Gy, P = 1.0. Mean V20 was the same in both cohorts, 3.3%. Conclusions The dosimetry for 3D‐CRT and VMAT plans were not significantly different including V5, and therefore we conclude that VMAT treatment is unlikely to be associated with an increased risk of radiation pneumonitis. |
| first_indexed | 2024-04-10T06:22:50Z |
| format | Article |
| id | doaj.art-72485ec046f145b1bd668b48c52cc3f8 |
| institution | Directory Open Access Journal |
| issn | 2051-3895 2051-3909 |
| language | English |
| last_indexed | 2024-04-10T06:22:50Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Medical Radiation Sciences |
| spelling | doaj.art-72485ec046f145b1bd668b48c52cc3f82023-03-02T03:09:49ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092023-03-01701728010.1002/jmrs.634Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR)Frances Mark0Anoud Alnsour1Scott N. Penfold2Adrian Esterman3Robert Keys4Hien Le5Department of Radiation Oncology Royal Adelaide Hospital Adelaide South Australia AustraliaKing Hussein Cancer Center –KHCC Amman JordanAustralian Bragg Centre for Proton Therapy and Research Adelaide South Australia AustraliaClinical and Health Sciences University of South Australia Adelaide South Australia AustraliaDepartment of Radiation Oncology Royal Adelaide Hospital Adelaide South Australia AustraliaDepartment of Radiation Oncology Royal Adelaide Hospital Adelaide South Australia AustraliaAbstract Introduction Stereotactic ablative radiotherapy (SABR) can be a curative option for non‐small cell lung cancer (NSCLC) and oligometastatic lung disease. Volumetric modulated arc therapy (VMAT) has offered further advancements in terms of radiation dose shaping without compromising treatment times however there is potential for greater low‐dose exposure to the lung. This study was to assess whether VMAT lung SABR would result in any increase to the dosimetry parameters compared with three‐dimensional conformal radiotherapy (3D‐CRT) that could confer increased risk of radiation pneumonitis. Methods A total of 53 and 30 3D‐CRT treatment plans of patients treated with 48 Gy in 4 fractions were compared. Results No statistically significant difference in planning target volumes between the VMAT 29.9 cc (range 12.4–58.5 cc) and 3D‐CRT 31.2 cc (range 12.3–58.3 cc) P = 0.79. The mean of total lung V5, ipsilateral lung V5 and contralateral lung V5 all showed a trend of being smaller in the VMAT treatment group‐ 14% versus 15.8%, 25.6% versus 30.4% and 1.6% versus 2.2%, respectively, but all were not statistically significant differences. Mean of the mean lung dose MLD, again showed a trend of being lower in the VMAT treatments but was also non‐significant, 2.6 Gy versus 3.0 Gy, P = 1.0. Mean V20 was the same in both cohorts, 3.3%. Conclusions The dosimetry for 3D‐CRT and VMAT plans were not significantly different including V5, and therefore we conclude that VMAT treatment is unlikely to be associated with an increased risk of radiation pneumonitis.https://doi.org/10.1002/jmrs.634Non‐small cell lung cancerradiation pneumonitisstereotactic ablative radiotherapyV5volumetric modulated arc therapy |
| spellingShingle | Frances Mark Anoud Alnsour Scott N. Penfold Adrian Esterman Robert Keys Hien Le Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR) Journal of Medical Radiation Sciences Non‐small cell lung cancer radiation pneumonitis stereotactic ablative radiotherapy V5 volumetric modulated arc therapy |
| title | Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR) |
| title_full | Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR) |
| title_fullStr | Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR) |
| title_full_unstemmed | Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR) |
| title_short | Volumetric modulated arc therapy (VMAT) comparison to 3D‐conformal technique in lung stereotactic ablative radiotherapy (SABR) |
| title_sort | volumetric modulated arc therapy vmat comparison to 3d conformal technique in lung stereotactic ablative radiotherapy sabr |
| topic | Non‐small cell lung cancer radiation pneumonitis stereotactic ablative radiotherapy V5 volumetric modulated arc therapy |
| url | https://doi.org/10.1002/jmrs.634 |
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