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3D conformal, IMRT and VMAT for the treatment of head and neck cancer: a brief literature review

Published online by Cambridge University Press:  09 December 2020

Kazi T. Afrin  and
Salahuddin Ahmad Open the ORCID record for Salahuddin Ahmad [Opens in a new window]
Kazi T. Afrin
Affiliation:
Department of Medical Physics and Biomedical Engineering, Gono Bishwabidyalay, P.O. Mirzanagar, Savar, Dhaka, 1344, Bangladesh
Salahuddin Ahmad*
Affiliation:
Department of Radiation Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
*
Author for correspondence: Salahuddin Ahmad, Department of Radiation Oncology, University of Oklahoma Health Sciences Center, 800 NE 10th St, SCC L100, Oklahoma City, OK73104, USA. E-mail: Salahuddin-ahmad@ouhsc.edu
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Abstract

Aim:

The objective of this study has been to identify monitor unit (MU) and treatment time variations, volume coverage dissimilarity among 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) treatment plans for head and neck cancer (HNC) based on literature review.

Methods:

A number of HNC cases were studied with the investigation of conformity and homogeneity index.

Results:

When high-dose modulation was required around small organs at risk (OARs), a clinically acceptable IMRT plan was achieved as VMAT usually required longer dose optimisation time. The greatest benefit of VMAT has been rapid treatment delivery allowing improved patient comfort, reduced intra-fraction motion and increased patient throughput. In some papers, 3D-CRT was shown not to meet well the requirements on parotid glands. One paper showed that cerebellum dose was lower for 3D-CRT than IMRT. However, it was found in other papers that OAR sparing with 3D-CRT was reasonable but in complex cases not enough.

Conclusions:

IMRT usually consists of several treatment fields with different directions, hundreds of beam lets with modulated intensity, an advantage over 3D-CRT, whereas VMAT has advantage over IMRT due to rotating beam utilisation. VMAT has lower total MU and treatment times than IMRT and 3D-CRT, while maintaining similar dosimetric endpoints.

Keywords

Dosimetric comparison3D-CRTIMRTVMATHead & Neck Cancer
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 2 , June 2022 , pp. 259 - 262
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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