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Ege Journal of Medicine
2018, Cilt 57, Sayı 2, Sayfa(lar) 082-087
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The dosimetric comparison of intensity modulated radiotherapy and volumetric arc therapy in locally advanced uterine cervix cancer
Berna Nalbant1, Fatma Sert2, Emin Tavlayan2, Nezahat Olacak2, Zeynep Özsaran2
1Onkomer Onkoloji Merkezi, Radyasyon Fiziği, Bornova, Türkiye
2Ege Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Bornova, Türkiye
Keywords: Radiotherapy, intensity modulated radiotherapy, cervical cancer, volumetric arc therapy, delta-4 phantom

Aim: The standard treatment approach for locally advanced stage uterine cervix cancer is radio-chemotherapy. New radiotherapy techniques provide appropriate dose distributions with maximum tumor dose and minimum organ at risk doses. We aim to compare intensity modulated radiotherapy (IMRT) and volumetric arc therapy techniques in the cervix cancer treatment.

Materials and Methods: Ten computed tomographies (CT) of treated patients were used. Gross tumor volume (GTV), clinical tumor volume (CTV) both for tumor and lymph nodes and organ at risks were contoured. Treatment volumes were created by adding 1.5 cm margins to CTV tumor and lymph nodes. Totally 50.4 Gy doses with 1.8 Gy daily fraction were applied. Two techniques were compared in terms of dose volume histograms, homogenity index (HI), conformity Index (CI), monitory unit (MU) and segment numbers.

Results: For intestines, V40 Gy were 14.24% and 11.28% with IMRT and VMAT, respectively (p=0.022). For femoral heads, V30 Gy were 7.8% and 12.39% with IMRT and VMAT, respectively (p=0.007). The duration time of treatment was significantly short but MU value for each fraction was significantly high with VMAT technique. On the other hand, there could not find any difference in terms of HI and CI between two techniques.

Conclusion: The shortness of treatment duration can be seen as an advantage in terms of both patient comfort and machine performance in VMAT technique. IMRT and VMAT can be preferred for the treatment of locally advanced cervix cancer by taking into the conditions of our department.

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