International Journal of Hematology and Oncology 2018, Vol 28, Num 3 Page(s): 244-252
Which One is The Better Radiotherapy Technique for Patients with Thoracic Esophageal Tumors, IMRT or VMAT?

A. Emre KARAOGUZ1, Zümre A. ALICIKUS1, Dogukan AKCAY1, Hülya ELLIDOKUZ2, Kadir AKGUNGOR3

1Dokuz Eylul University, Faculty of Medicine, Department of Radiation Oncology, Izmir, TURKEY
2Dokuz Eylül University, Oncology Institute, Department of Biostatistics and Medical Informatics, Izmir, TURKEY
3Dokuz Eylül University, Faculty of Arts and Science, Izmir, TURKEY

Comparison of IMRT and VMAT techniques in thoracic esophageal tumors. IMRT and VMAT plans were created for a total of 10 thorax-located esophagus patients. All plans were compared in terms of HI and CI for PTV; V5, V10, V20 and mean lung dose parameters for total lung; V30, V40 and mean heart dose for the heart; and the Dmax for the medulla spinalis. IMRT and VMAT techniques yielded similar results with respect to HI and CI values (p> 0.05). Median mean lung dose was found to be lower in VMAT (11.77 Gy) technique compared to IMRT (12.05 Gy). While the lowest lung median V5 (67.17%) and V10 (41.95%) values belonged to IMRT, the V20 value was achieved with VMAT (17.85%) planning. Median mean heart dose was found the lowest in VMAT (28.81 Gy) and the highest IMRT (29.31 Gy) planning. The lowest heart median V30 value was obtained with IMRT (43.00%) and median V40 value was obtained with VMAT (18.95%) planning. The median mean medulla spinalis maximum dose was found to be lower with VMAT (41.54 Gy), with no statistically significant difference between them (p= 0.074). VMAT technique was better for reducing cardiovascular and medulla spinalis doses with reduced duration of treatment time and dosimetric uncertainties, while YART technique provides higher PTV control with less low-dose lung volume. Both threatment options have advantages and disadvantages over normal tissue and tumor volume compared to each other, and should be evaluated according to the other clinical conditions of the patient.