Dosimetric comparison of Three Dimensional Conformal Radiation Therapy (3DCRT) and Posterior Partial Arc Volumetric Modulated Arc Therapy (VMAT) Plan for Craniospinal Irradiation.

Document Type : Original Paper

Authors

1 ASSISTANT PROFESSOR, DEPARTMENT OF RADIOTHERAPY AND ONCOLOGY,MEDICAL RADIATION PHYSICS PROGRAM, MANIPAL COLLEGE OF HEALTH PROFESSIONS(MCHP), MANIPAL ACADEMY OF HIGHER EDUCATION(MAHE), MANIPAL-576104, KARNATAKA, INDIA

2 Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India.

3 Radiotherapy and Oncology Senior Grade Lecturer Medical Physics Kasturba Medical College Manipal Academy of Higher Education Manipal India

4 Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India. Manipal 576104

10.22038/ijmp.2023.69373.2225

Abstract

Introduction: This study compares three dimensional conformal radiotherapy (3DCRT) and Posterior Partial Arc volumetric modulated arc therapy (VMAT) planning techniques for treating craniospinal irradiation.

Materials and Methods: Ten patients with Medulloblastoma were retrospectively considered for the study and replanned using 3DCRT and posterior partial arc VMAT techniques using MONACO 5.11, treatment planning system (TPS). The dose prescribed for the planning target volume(PTV) was 36Gy in 20 Fractions, followed by a boost dose to the brain volume. The parameters such as Tumor coverage, the organ at risk(OAR) doses, conformity index(CI), homogeneity index(HI), and total monitor units(MU) were calculated for both plans. Comparison of the two planning techniques done using paired sample t-test.

Results: PTV coverage in VMAT and 3DRT was 97.994±2.2533 and 94.041±2.24907, respectively. The mean CI in 3DCRT and VMAT was 1.3459±0.3279 and 1.1714±0.1238, respectively, and the mean HI in 3DCRT and VMAT was 1.1151±0.0247 and 1.0634±0.0198, respectively. OAR doses were comparable in 3DCRT and VMAT. The total MU in 3DCRT and VMAT were 198.12±8.9539 and 978.403±170.0104, respectively.

Conclusion: Posterior Partial Arc VMAT plans are superior to 3DCRT in target coverage, conformity index, and homogeneity index. The OAR doses in the two planning techniques were comparable whereas, the duration of treatment was higher in VMAT compared to the 3DCRT method. Additionally, low dose volumes are reduced in VMAT due to partial posterior arcs. Considering all the factors, it can be concluded from the study that Posterior Partial Arc VMAT plans are superior to 3DCRT.

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Articles in Press, Accepted Manuscript
Available Online from 06 February 2023
  • Receive Date: 05 December 2022
  • Revise Date: 30 January 2023
  • Accept Date: 06 February 2023
  • First Publish Date: 06 February 2023