DOSIMETRIC COMPARISON OF 3 DIMENSIONAL CONFORMAL RADIOTHERAPY (3DCRT) AND VOLUMETRIC MODULATED ARC THERAPY (VMAT) TECHNIQUE IN CASES OF DIAGNOSED THORACIC ESOPHAGEAL CANCER PATIENTS: A RETROSPECTIVE STUDY

Abstract

3BKRT and VMAT techniques used in radiotherapy treatment of esophageal cancer to see the effects of protecting risk organs while achieving target volume and obtain their own data, to compare there retrospective dosimetric results with each other. For This study; 10 patient thoracic esophageal cancer patients were selected that treated with curative radiotherapy. Plans were prepared  the fraction would be 1,8 Gy and totally 54 Gy.  Critical organs, CI and HI were compared between two techniques. As a result of the statistical comparisons showed no significant difference between 3BKRT and VMAT except for HI (p = 0,010) in the analysis of  the values of PTV54. For OAR doses; value of the lung V₁₀ was found to be supeior to the 3BKRT technique (p=0,017). The V₄₀ value of the heart was found to be low in the VMAT technique (p = 0.002). Additionally, for spinal cord D_max value, VMAT technique has lower values than 3BKRT (p = 0.001).  As  results of our study, although both techniques could be used in terms of dose homogenity and risk of organs, the use of  VMAT technique might be preferable to consider of the comorbidities affecting these older patients.

Keywords

• Esophageal cancer,radiotherapy,VMAT,3DCRT

Toraks Yerşimli Özofagus Kanseri Tanılı Olgularda 3 Boyutlu Konformal Radyoterapi (3BKRT) ve Hacimsel Ayarlı Ark Terapi (Vmat) Tekniğinin Dozimetrik Karşılaştırması: Retrospektif Çalışma

Abstract

Özofagus kanserinin radyoterapi ile tedavisinde kullanılan 3BKRT ve VMAT tekniklerinin hedef hacmi sararken riskli organları korumadaki etkilerini görmek ve kendi verilerini elde etmek; elde ettiğimiz bu retrospektif dozimetrik sonuçları birbirleriyle karşılaştırmaktır. Bu çalışma için; 10 küratif radyoterapi ile tedavi edilen toraks yerleşimli özofagus kanseri tanılı hasta seçildi. Fraksiyon dozu 1,8 Gy ve toplam doz 54 Gy olacak şekilde planlar hazırlandı. İki teknik arasında kritik organ dozu (OAR), CI ve HI karşılaştırıldı. Yapılan istatistiksel karşılaştırma sonucunda PTV54’e ait değerlerin analizinde 3BKRT ve VMAT arasında HI (p=0,010)  dışında anlamlı fark görülmemiştir. OAR dozları için; akciğerin V₁₀ değeri  3BKRT tekniğinde üstün bulunmuştur (p=0,017). Kalbin V₄₀ değeri VMAT tekniğinde düşük bulunmuştur (p=0,002). Ayrıca, Spinal Cord D_max değeri için bakıldığında VMAT tekniği 3BKRT’ye göre düşük değerlere sahiptir (p=0,001). Çalışmamızın sonucunda doz homojenliği ve riskli organlar açısından her iki teknikte kullanılabilir görülmesine rağmen ileri yaştaki bu hastalarda etki eden komorbiditeler göz önüne alındığında VMAT tekniği kullanımının tercih olabileceği görülmüştür.

Keywords

• Özofagus kanseri,radyoterapi,VMAT,3BKRT

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