title: Bladder radiotherapy treatment: A retrospective comparison of 3-dimensional conformal radiotherapy, intensity-modulated radiation therapy, and volumetric-modulated arc therapy plans.
abstract: To examine tumor׳s and organ׳s response when different radiotherapy plan techniques are used. Ten patients with confirmed bladder tumors were first treated using 3-dimensional conformal radiotherapy (3DCRT) and subsequently the original plans were re-optimized using the intensity-modulated radiation treatment (IMRT) and volumetric-modulated arc therapy (VMAT)-techniques. Targets coverage in terms of conformity and homogeneity index, TCP, and organs׳ dose limits, including integral dose analysis were evaluated. In addition, MUs and treatment delivery times were compared. Better minimum target coverage (1.3%) was observed in VMAT plans when compared to 3DCRT and IMRT ones confirmed by a statistically significant conformity index (CI) results. Large differences were observed among techniques in integral dose results of the femoral heads. Even if no statistically significant differences were reported in rectum and tissue, a large amount of energy deposition was observed in 3DCRT plans. In any case, VMAT plans provided better organs and tissue sparing confirmed also by the normal tissue complication probability (NTCP) analysis as well as a better tumor control probability (TCP) result. Our analysis showed better overall results in planning using VMAT techniques. Furthermore, a total time reduction in treatment observed among techniques including gantry and collimator rotation could encourage using the more recent one, reducing target movements and patient discomfort.
authors.affiliation: Department of Radiotherapy Physics, Royal Free Hospital, London, UK. Electronic address: k.pasciuti@virgilio.it.
authors.forename: Katia
authors.initials: K
authors.lastname: Pasciuti
authors.affiliation: Department of Radiotherapy, Royal Free Hospital, London, UK.
authors.forename: Shrinivas
authors.initials: S
authors.lastname: Kuthpady
authors.affiliation: Department of Radiotherapy Physics, Royal Free Hospital, London, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Anderson
authors.affiliation: Department of Radiotherapy Physics, Royal Free Hospital, London, UK.
authors.forename: Bronagh
authors.initials: B
authors.lastname: Best
authors.affiliation: Department of Radiotherapy, Royal Free Hospital, London, UK.
authors.forename: Saleem
authors.initials: S
authors.lastname: Waqar
authors.affiliation: Department of Radiotherapy, Royal Free Hospital, London, UK.
authors.forename: Subhra
authors.initials: S
authors.lastname: Chowdhury
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy*
keywords: IMRT; Integral dose; NTCP; TCP; VMAT