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Intensity-modulated radiation therapy versus volumetric-modulated arc therapy in non-small cell lung cancer: assessing the risk of radiation pneumonitis

Published online by Cambridge University Press:  06 June 2017

Sara Rosas ,
Bárbara Barbosa  and
José G. Couto
Sara Rosas*
Affiliation:
Radiotherapy Department, Escola Superior de Tecnologia da Saúde do Porto, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
Bárbara Barbosa
Affiliation:
Radiotherapy Department, Escola Superior de Tecnologia da Saúde do Porto, Rua Valente Perfeito, Vila Nova de Gaia, Portugal Radiotherapy Department, Instituto Português de Oncologia do Porto, Rua Doutor António Bernardino de Almeida, Porto, Portugal
José G. Couto
Affiliation:
Radiotherapy Department, Escola Superior de Tecnologia da Saúde do Porto, Rua Valente Perfeito, Vila Nova de Gaia, Portugal Radiotherapy Department, Instituto Português de Oncologia do Porto, Rua Doutor António Bernardino de Almeida, Porto, Portugal
*
Correspondence to: Sara Rosas, Paul Scherrer Institut, WPTA/139, 5232 Villigen PSI, Switzerland. Tel: +41 56 310 56 13. E-mail: Sara.Rosas@psi.ch
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Abstract

Purpose

This study aimed to compare intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) regarding plan quality and healthy lung sparing, in stage III non-small cell lung cancer (NSCLC) patients.

Materials and methods

The plans of 60 patients were allocated either to the IMRT (n=30) or the VMAT (n=30) group. The dose prescribed to the planning target volume (PTV) was evaluated at the 95% level and the mean lung dose (MLD) and the healthy lung receiving 5, 10 and 20 Gy (V5, V10 and V20, respectively) were analysed. The normal tissue complication probability (NTCP) for radiation pneumonitis was calculated with the Lyman–Kutcher–Burman model.

Results

Both techniques achieved comparable results for target coverage (V95%=97·87 versus 97·18%, p>0·05) and homogeneity. The MLD (15·57 versus 16·98 Gy, p>0·05), V5 (60·35 versus 67·25%, p>0·05) and V10 (45·22 versus 53·14%, p=0·011) were lower for IMRT, whereas VMAT reduced V20 (26·44 versus 25·90%, p>0·05). The NTCP for radiation pneumonitis was higher for VMAT, but no statistical significance was observed (11·07 versus 12·75, p>0·05).

Conclusion

Both techniques seemed suitable for NSCLC treatment, but IMRT presented better results regarding lung sparing thus being beneficial in reducing the risk of radiation-induced pneumonitis.

Keywords

IMRTNSCLCNTCPradiation pneumonitisVMAT
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 1 , March 2018 , pp. 6 - 11
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Copyright
© Cambridge University Press 2017 

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