A Dosimetric Comparison Study of 3-Dimensional Conformal Radiotherapy (3D-CRT), Intensity-Modulated Radiotherapy (IMRT), and Volumetric-Modulated Arc Therapy (VMAT) in Complete-Resection, Pediatric, Abdominal Neuroblastoma

Authors

  • Teeradon Treechairusame Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Nan Suntornpong Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Kullathorn Thephamongkhol Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Porntip Ieumpongpaibool Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700
  • Warissara Rongthong Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700

Keywords:

pediatric neuroblastoma, dosimetric study, 3D-CRT, IMRT, VMAT

Abstract

Background: Advanced radiotherapy techniques—intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT)—deliver low peripheral radiation doses but full doses to desired target volumes and shortening treatment. However, potential late effects related to integral doses and secondary malignancy risks are concerned.

Objective: To compare the dosimetries of 3-Dimensional Conformal Radiotherapy (3D-CRT), IMRT and VMAT in terms of tumor coverage and organ-at-risk (OAR) sparing in neuroblastoma.

Materials and Methods: Patients aged 1 month–15 years, had completely resected high-risk abdominal neuroblastoma, and received radiotherapy. Treatment planning was reperformed for 3D-CRT, IMRT, and VMAT. Patients were divided into 2 subsgroups; radical nephrectomy and non-radical nephrectomy groups then dosimetric data were analyzed.

Results: Among 3D-CRT, IMRT and VMAT, V95% constraint, mean homogeneity indexes and integral doses were not significantly different. Conformity indexes were statistically lower for IMRT and VMAT than 3D-CRT. In the non-radical-nephrectomy group, IMRT and VMAT were superior to 3D-CRT in terms of V18Gy to ipsilateral kidneys and contralateral kidneys. In the radical-nephrectomy group, V18Gy of contralateral kidneys was within dose constraint for 3/4 patients with 3D-CRT  but all patients with IMRT and VMAT. Mean V15Gy of liver volume were significantly different among 3 techniques, but V8Gy did not show significant difference. The means for D80% of the spine were not significantly different. Overall passing rates were 12.55% (3D-CRT), 62.5% (IMRT) and 87.5% (VMAT).

Conclusions: IMRT and VMAT had superior OAR sparing (especially the kidneys), without compromising target coverage, than 3D-CRT in all cases.

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Published

2020-10-21

How to Cite

1.
Treechairusame T, Suntornpong N, Thephamongkhol K, Ieumpongpaibool P, Rongthong W. A Dosimetric Comparison Study of 3-Dimensional Conformal Radiotherapy (3D-CRT), Intensity-Modulated Radiotherapy (IMRT), and Volumetric-Modulated Arc Therapy (VMAT) in Complete-Resection, Pediatric, Abdominal Neuroblastoma. J Thai Assn of Radiat Oncol [Internet]. 2020 Oct. 21 [cited 2024 Nov. 15];26(2):R89-R105. Available from: https://he01.tci-thaijo.org/index.php/jtaro/article/view/241016

Issue

Vol. 26 No. 2 (2020): July - December

Section

Original articles

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