Dosimetric Comparison of Volumetric Arc Therapy and Helical Tomotherapy in Locally Advanced Non-Small Cell Lung Cancer
DOI:
https://doi.org/10.63187/ampas.34Keywords:
Non-small cell lung cancer, radiotherapy, Helical Tomotherapy, VMAT, dosimetric comparisonAbstract
Radiotherapy (RT) in lung cancer emphasizes the use of modern techniques due to the size of the treatment area and doses to critical organs. This study aimed to evaluate dosimetric differences between Helical Tomotherapy (HT) and Volumetric Arc Radiotherapy (VMAT) plans and which technique is more appropriate in patients with stage IIIB inoperable non-small cell lung cancer (NSCLC).
Fifteen patients with stage IIIB inoperable NSCLC and a planning target volume (PTV) >200 cc or length >10 cm, treated between January 2024 and December 2024, were included. A prescription of 60 Gy in 30 fractions was applied. Plans were evaluated using conformity index (CI), homogeneity index (HI), and doses to critical organs.
The median PTV volume was 385 cc (range: 213–615 cc). Both planning techniques covered 98% of the prescribed dose (p = 0.887), but HT demonstrated significantly better HI (p = 0.011). HT also yielded significantly lower doses in total lung V5, contralateral lung V5, heart mean dose, heart V50, and spinal cord max dose. Esophageal doses showed no significant differences. Although dose constraints for the esophagus were met in both planning systems, a lower dose was achieved with HT."
Modern planning systems can achieve desired doses in large volume targets while remaining within dose limits for organs at risk. HT provided significant advantages in critical organ sparing and better homogeneity in dose distribution. The selection of the appropriate technique should be determined based on the characteristics of the tumor and the specific needs of the patient.
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Copyright (c) 2025 NİLGÜL NALBANT, PHILIPP SCHİLLİNG, DAMLA POYRAZ, ERTUĞRUL TEKÇE, ZEYNEP GÜRAL, SERAP YÜCEL, FULYA AĞAOĞLU
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