Comparison of Volumetric Modulated ARC Therapy (VMAT) to Conventional Intensity Modulated Radiation Therapy for Carcinoma Cervix
Journal Title: Indian Journal of Cancer Education and Research - Year 2017, Vol 5, Issue 2
Abstract
Introduction: Cervical cancer is the second most common cancer in women worldwide and in India, the fifth most common cancer in humans. Two new techniques of radiation therapy in cervical cancer have been widely shown interest in treatment, i.e., IMRT and VMAT. VMAT has proven superiority over conventional radiotherapy with regard to dose conformity and organ sparing. Aim: In this present study, we propose to compare VMAT with IMRT in terms of target coverage (homogeneity and conformity indices) and dose to organs at risk (OARs) by means of dosimetric studies in patients of cervical cancer. Materials and Methods: The present study was conducted in Inlaks & Budhrani hospital, a state of art cancer institute from September 2013 to February 2015 to compare the technique of VMAT to IMRT. All the cervical cancer patients as per inclusion and exclusion criteria who opted for either VMAT or IMRT were included in our Study, Thus a total of 63 patients were recruited of which 33 opted for IMRT and 30 opted for VMAT. Results: 98% of the patients included in our study were in the age group of 4069yrs. Age didn’t show to affect the results of the acute or chronic toxicities during our study period. 76% of VMAT patients and 67% of IMRT patients were of Stage IIB. Stage IIB was the most common stage of presentation in our study. After it, 23% of VMAT patients and 27% of IMRT patients were of Stage IIIB. FIGO stage is an established prognostic factor for survival. Both the techniques have almost similar number of patients of same stage of disease. Squamous cell carcinoma was the most common histopathological diagnosis in 89% of the patients combined.. VMAT proved to be better than IMRT when it comes to mean dose to bladder and rectum, and it was statistically significant. VMAT failed to show superiority over IMRT in mean dose to bowel bag, right and left femoral head. VMAT and IMRT reported similar target coverage. Uniformity index, heterogeneity index and conformity index between the treatment techniques didn’t show any difference. VMAT didn’t prove to be superior over IMRT when it comes to acute and chronic toxicities of gastrointestinal, genitourinary or hematological systems. Conclusion: Within limitations of the present study we found no significant difference between IMRT and VMAT was observed except VMAT showed superiority to IMRT only in minimizing dose to bladder and rectum
Authors and Affiliations
U. Umamaheswara Reddy
Keywords
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- EP ID EP461045
- DOI 10.21088/ijcer.2321.9815.5217.10
- Views 94
- Downloads 0
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