Akademik Veri Yönetim Sistemi
International Journal of Radiation Research, cilt.22, sa.3, ss.617-623, 2024 (SCI-Expanded)
Background: This study aims to compare the radiation doses delivered to the heart and left anterior descending artery (LAD) when using Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiotherapy (IMRT) for the treatment of left-sided lung cancer. Materials and Methods: We selected 29 stage III lung cancer patients for replanning. Step and shoot IMRT(S&S-IMRT), dynamic IMRT(D-IMRT), full arc VMAT (FA-VMAT) and two partial arc VMAT (2PA-VMAT) techniques were used in plan recreation for each patient. Difference between heart and LAD doses were investigated using dose volume histogram. Results: FA-VMAT technique resulted in lower LAD mean (Dmean) (1712.43 cGy, p < 0.001), LAD maximum (Dmax), LAD 2% (D2%) (3527.33 cGy, p = 0.003), LAD 0.1cc (D0.1cc) (3473.12 cGy, p=0.006) doses and percentage of LAD that received 15Gy (V15) (43.69%, p < 0.001). No statistical difference was observed between the two partial arc VMAT and full arc VMAT techniques in LAD doses. Comparing cardiac V10, V15, and heart mean doses (MHD), the 2PA-VMAT technique showed better organ protection than FA-VMAT, S&S IMRT, and D-IMRT.2PA-VMAT and FA-VMAT showed similar results in cardiac V5, V20, V25, V30, V40 and V45 values. When the median heart volume (567 cc) was used as a threshold, those with heart volume smaller than 567cc had statistically significant differences in LAD and heart doses in favor of 2PA-VMAT (p < 0.005). Conclusion: VMAT technique protects LAD and heart better than IMRT technique in left-sided lung cancer patients.