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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1428329
This article is part of the Research Topic Radiotherapy for Head and Neck Cancers View all 12 articles

A dosimetric comparison of non-coplanar volumetric modulated arc therapy and non-coplanar fixed field intensity modulated radiation therapy in the hippocampus-avoidance whole-brain radiation therapy with a simultaneous integrated boost for brain metastases

Provisionally accepted
Huaqu Zeng Huaqu Zeng 1*MinZhi Zhong MinZhi Zhong 2Zongyou Chen Zongyou Chen 1Shukui Tang Shukui Tang 1Zunbei Wen Zunbei Wen 1
  • 1 Other, Gaozhou, China
  • 2 Department of Radiology, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, China

The final, formatted version of the article will be published soon.

    To investigate the dosimetric differences between non-coplanar VMAT and IMRT of the hippocampus-avoidance whole-brain radiation therapy with a simultaneous integrated boost .A total of 22 patients with brain metastases were retrospectively enrolled.Two radiotherapy treatment plans were designed for each patient, VMAT and IMRT. The dose distribution of targets and organs at risk , the number of MU and pre-treatment plan verification were compared between the two plans while meeting the prescribed dose requirements of the target volume. Results There were no significant differences in V50, V55, Dmax, HI and CI of target PGTV between the two plans (p>0.05). For PTV-brain-SIB, there was no significant difference in D98% between IMRT and VMAT (p=0.103). VMAT could significantly improve the V30 of PTV-brain-SIB (p<0.001), decreased HI (p=0.003) and increased CI (p<0.001). There were no significant differences in the Dmax to the brain stem, left and right lens, optic chiasm, pituitary gland, and left and right hippocampus between the two plans (p>0.05). .There was no significant difference in the Dmax to the left and right hippocampus between VMAT and IMRT(p>0.05), but VMAT significantly increased the D100% (p<0.05) compared with IMRT.Compared with VMAT, IMRT significantly reduced the MU (p<0.001) but VMAT has a higher treatment efficiency than IMRT, with an average reduction of 41 seconds (294.1 ± 16.4 s for VMAT, 335.8 ± 34.9 s for IMRT, p<0.001). Under the conditions of 3% / 2 mm, and 2% / 2 mm criterion, the gamma passing rate of the IMRT QA was improved compared to VMAT, with an average increase of 0.6%, p=0.013, and 1.7%, p<0.001 respectively.Both VMAT and IMRT based on the Monaco TPS produce clinically acceptable results for HA-WBRT+SIB . Compared with IMRT, VMAT has better dose distribution in the target volume and treatment efficiency, but IMRT can better protect the hippocampus and reduce the number of MU.

    Keywords: Hippocampus sparing, brain metastases, Simultaneous integrated boost, Whole brain radiotherapy, volumetric modulated arc therapy, Intensity Modulated Radiotherapy

    Received: 06 May 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Zeng, Zhong, Chen, Tang and Wen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Huaqu Zeng, Other, Gaozhou, China

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