title: Dosimetric comparisons of VMAT, IMRT and 3DCRT for locally advanced rectal cancer with simultaneous integrated boost.
abstract: The simultaneous integrated boost radiotherapy for preoperative locally advanced rectal cancer (LARC) can improve the local control and overall survival rates. The purpose of this study is to compare the dosimetric differences among volumetric modulated arc therapy (VMAT), fixed-field intensity modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT) for the LARC. Ten LARC patients treated in our department using the simultaneous escalate strategy were retrospectively analyzed in this study. All patients had T3 with N+/- and were treated with IMRT. Two additional VMAT and 3DCRT plans were created for each patient. VMAT plans were designed using SmartArc planning module. Both IMRT and SmartArc had similar optimization objectives. The prescription was 50 Gy to the planning clinical target volume (PTV-C) and 56 Gy to the planning gross target volume (PTV-G). The target coverage and organs at risk (OARs) were compared for all the techniques. The paired, two-tailed Wilcoxon signed-rank test was applied for statistical analysis. Results of this study indicate that IMRT and SmartArc were all significantly superior to 3DCRT in most of the relevant values evaluated of target response, OARs and normal tissue sparing. They provided comparable dosimetric parameters for target volume. But IMRT shows better sparing for OARs and normal tissue.
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Weigang
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Cai
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Jiazhou
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Jiayuan
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012004:Rectal Neoplasms / Q000532:radiotherapy*
keywords: VMAT; dose comparison; rectal radiotherapy