Dosimetric Outcomes of IMRT and VMAT in Head and Neck Radiotherapy: Retrospective Institutional Experience.
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| Format: | Recurso digital |
| Sprache: | Englisch |
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2025
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| _version_ | 1866902222028144640 |
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| author | Sunil Kumar |
| author_facet | Sunil Kumar |
| contents | <p><strong><em><span>Abstract</span></em></strong></p> <p><strong><em><span lang="EN-US">Background: </span></em></strong><em><span lang="EN-US">Head and neck cancers (HNC) pose significant challenges for radiotherapy due to their proximity to critical organs-at-risk (OARs). While intensity-modulated radiation therapy (IMRT) remains the gold standard for dose conformity, volumetric modulated arc therapy (VMAT) has emerged as a promising advancement, offering dynamic arc-based delivery with potential gains in efficiency and dosimetric precision.</span></em></p> <p><strong><em><span lang="EN-US">Objective:</span></em></strong><em><span lang="EN-US"> To compare the dosimetric performance of IMRT and VMAT in HNC radiotherapy, focusing on target coverage, OAR sparing, treatment efficiency, and plan quality.</span></em></p> <p><strong><em><span lang="EN-US">Methods:</span></em></strong><em><span lang="EN-US"> In this retrospective study, 40 patients with histologically confirmed head and neck squamous cell carcinoma (HNSCC) underwent dual planning (IMRT and VMAT) using identical target volumes and dose constraints. Dosimetric parameters including PTV coverage (D95%), mean/maximum OAR doses, homogeneity index (HI), conformity index (CI), and monitor units were analyzed. Statistical comparisons used paired t-tests (SPSS v26).</span></em></p> <p><strong><em><span lang="EN-US">Results:</span></em></strong><em><span lang="EN-US"> Both modalities achieved clinically acceptable PTV coverage. VMAT demonstrated superior dose conformity (CI: 1.16 vs. 1.18, p < 0.05) and homogeneity (HI: 0.050 vs. 0.056, p < 0.05) compared to IMRT. VART significantly reduced maximum doses to the spinal cord (27.61 vs. 28.71 Gy, p < 0.05) and PRV cord (31.39 vs. 32.58 Gy, p < 0.05), while lowering mean dose of mandible (62.13 vs. 65.13 Gy, p < 0.05) and mean of skin Dmax (65.01 vs. 65.81 Gy, p < 0.05).</span></em></p> <p><strong><em><span lang="EN-US">Conclusion:</span></em></strong><em><span lang="EN-US"> VMAT outperformed IMRT in HNC radiotherapy, delivering superior dose homogeneity, conformity, and OAR sparing while significantly shortening treatment time. These advantages position VMAT as the preferred modality for balancing efficacy with reduced toxicity risks in clinical practice.</span></em></p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_17285005 |
| institution | Zenodo |
| language | eng |
| publishDate | 2025 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Dosimetric Outcomes of IMRT and VMAT in Head and Neck Radiotherapy: Retrospective Institutional Experience. Sunil Kumar <p><strong><em><span>Abstract</span></em></strong></p> <p><strong><em><span lang="EN-US">Background: </span></em></strong><em><span lang="EN-US">Head and neck cancers (HNC) pose significant challenges for radiotherapy due to their proximity to critical organs-at-risk (OARs). While intensity-modulated radiation therapy (IMRT) remains the gold standard for dose conformity, volumetric modulated arc therapy (VMAT) has emerged as a promising advancement, offering dynamic arc-based delivery with potential gains in efficiency and dosimetric precision.</span></em></p> <p><strong><em><span lang="EN-US">Objective:</span></em></strong><em><span lang="EN-US"> To compare the dosimetric performance of IMRT and VMAT in HNC radiotherapy, focusing on target coverage, OAR sparing, treatment efficiency, and plan quality.</span></em></p> <p><strong><em><span lang="EN-US">Methods:</span></em></strong><em><span lang="EN-US"> In this retrospective study, 40 patients with histologically confirmed head and neck squamous cell carcinoma (HNSCC) underwent dual planning (IMRT and VMAT) using identical target volumes and dose constraints. Dosimetric parameters including PTV coverage (D95%), mean/maximum OAR doses, homogeneity index (HI), conformity index (CI), and monitor units were analyzed. Statistical comparisons used paired t-tests (SPSS v26).</span></em></p> <p><strong><em><span lang="EN-US">Results:</span></em></strong><em><span lang="EN-US"> Both modalities achieved clinically acceptable PTV coverage. VMAT demonstrated superior dose conformity (CI: 1.16 vs. 1.18, p < 0.05) and homogeneity (HI: 0.050 vs. 0.056, p < 0.05) compared to IMRT. VART significantly reduced maximum doses to the spinal cord (27.61 vs. 28.71 Gy, p < 0.05) and PRV cord (31.39 vs. 32.58 Gy, p < 0.05), while lowering mean dose of mandible (62.13 vs. 65.13 Gy, p < 0.05) and mean of skin Dmax (65.01 vs. 65.81 Gy, p < 0.05).</span></em></p> <p><strong><em><span lang="EN-US">Conclusion:</span></em></strong><em><span lang="EN-US"> VMAT outperformed IMRT in HNC radiotherapy, delivering superior dose homogeneity, conformity, and OAR sparing while significantly shortening treatment time. These advantages position VMAT as the preferred modality for balancing efficacy with reduced toxicity risks in clinical practice.</span></em></p> |
| title | Dosimetric Outcomes of IMRT and VMAT in Head and Neck Radiotherapy: Retrospective Institutional Experience. |
| url | https://doi.org/10.5281/zenodo.17285005 |