A dosimetric and treatment efficiency evaluation of stereotactic body radiation therapy for peripheral lung cancer using flattening filter free beams
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Ji-Yong Zhang1,*, Jia-Yang Lu1,*, Li-Li Wu1,*, Dan-Li Hong2, Chang-chun Ma1, Xun Peng1, Zhi-Xiong Lin1
1Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, Shantou 515031, China
2Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515031, China
*These authors have contributed equally to this work
Xun Peng, email: [email protected]
Zhi-Xiong Lin, email: [email protected]
Keywords: dosimetric benefits, stereotactic body radiation therapy, flattening filter free beams, lung cancer
Received: June 13, 2016 Accepted: September 05, 2016 Published: September 16, 2016
To investigate potential dosimetric benefits and treatment efficiency of dynamic conformal arc therapy (DCA), intensity modulated radiation therapy (IMRT), and double partial arcs Rapidarc (RA) techniques in the treatment of early-stage peripheral lung cancer using stereotactic body radiotherapy (SBRT) with flattening filter free (FFF) beams. Twenty early-stage peripheral lung cancer patients were selected. For each patient, DCA, IMRT and RA plans were created to meet Radiation Therapy Oncology Group (RTOG) 0915 objectives with 48 Gy covering 95% of the planning target volume (PTV) in 4 fractions. PTV coverage, organs at risk (OARs) doses, planning time, monitor units (MU) and treatment time were evaluated. RA was significantly better than DCA for PTV coverage. RA provided a lower V32Gy to chest wall and less V20Gy to lung over those of DCA and IMRT. For other OARs, there is no significant difference among all three techniques. DCA plans showed significantly less planning time, shorter treatment time and lower MU number than those of RA and IMRT. RA provides a superior dosimetric benefit to DCA and IMRT in the treatment of early-stage lung cancer using SBRT with FFF beams. Considering the MU number, planning time and treatment efficiency, DCA technique is an effective treatment strategy.
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