Oesophageal Cancer: Conformal Radiotherapy vs. Hybrid-VMAT Technique With Two Different Treatment Planning Systems

Abstract

Background/Aim: Traditionally, the radiotherapy of oesophageal cancer has been conformal radiotherapy (CRT). We sought to compare dosimetric parameters of conformal radiotherapy (CRT) with those of two treatment planning systems for hybrid-volumetric modulated arc therapy (h-VMAT) for the treatment of oesophageal cancer. Patients and Methods: In 11 patients, we compared: i) planning target volume coverage, ii) dose to organs at risk, and iii) the dose rate (DR) of the three techniques. We evaluated two treatment planning systems: i) Eclipse and ii) RayStation. Results: The Conformity Index of the CRT plan was significantly higher for the h-VMAT plans, compared to all other parameters. Normal lung tissue volumes receiving >5, 13, or 20 Gy were lower with the RayStation plan compared to Eclipse. The volume of cardiac tissue receiving >40 Gy was highest with the CRT plan. The minimum DR in VMAT was lowest for the RayStation plan (49.5 MU/min). Conclusion: The h-VMAT plan using RayStation is the appropriate choice for reducing lung dose.