Improvement in Coronary Dose Distribution Using Dynamic Swing Arc in Volumetric-modulated Arc Therapy During Esophageal Cancer Radiotherapy.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-09-01 DOI:10.21873/invivo.14082

Kouta Hirotaki, Kenji Makita, Masashi Wakabayashi, Hidehiro Hojo, Satoe Kitou, Kento Tomizawa, Masashi Ito, Takeji Sakae

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Abstract

Background/aim: The dose to the left anterior descending coronary artery (LAD) is associated with mortality in patients with esophageal cancer (EC) who underwent radiotherapy. The aim of this study was to compare the dose distributions to the LAD region achieved through volumetric-modulated arc therapy (VMAT) planning using a dynamic swing arc in OXRAY (DSA-VMAT) and conventional coplanar (Conv-VMAT) planning.

Patients and methods: Ten patients with EC who had undergone radiotherapy (60 Gy in 30 fractions) at our Institution were selected for inclusion in the study. Two virtual plans (DSA-VMAT and Conv-VMAT) were created to compare the dose distributions of the LAD region, heart, lungs, and planning target volume (PTV). All plans were analyzed using paired t-tests.

Results: The mean values±standard deviation for 15 Gy to the LAD region (V15) were 10.48±13.04% for DSA-VMAT and 30.28±23.56% for Conv-VMAT. Compared with Conv-VMAT, DSA-VMAT significantly improved V15 of the LAD region (p=0.01). In addition, DSA-VMAT significantly reduced the mean heart dose (8.64±5.37 vs. 11.23±7.37 Gy), heart V40 (17.55±4.76% vs. 20.44±6.06%), lung V20 (14.87±5.93% vs. 17.81±7.70%), and lung V5 (57.27±8.24% vs. 61.15±9.97%) compared to Conv-VMAT (all p≤0.01). In contrast, there were no significant differences between the two groups in PTV dose coverage [D95 (p=0.61), D50 (p=0.62)], or conformity index (p=0.91).

Conclusion: Compared with Conv-VMAT, DSA-VMAT improved the dose distribution of the LAD region without impairing the PTV dose coverage. Thus, DSA-VMAT may reduce radiation-induced heart disease in patients with EC without loss of efficacy.

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食管癌放射治疗中使用动态摆动弧线改善冠状动脉剂量分布。

背景/目的：食管癌（EC）放射治疗患者的左冠状动脉前降支（LAD）剂量与死亡率相关。本研究的目的是比较使用动态摆弧OXRAY （DSA-VMAT）和传统共面（convv -VMAT）计划的体积调制弧线治疗（VMAT）计划获得的LAD区域剂量分布。患者和方法：选择10例在我院接受放疗（30次60 Gy）的EC患者纳入研究。创建两个虚拟计划（DSA-VMAT和convv - vmat）来比较LAD区域、心脏、肺部和计划靶体积（PTV）的剂量分布。所有计划采用配对t检验进行分析。结果：DSA-VMAT在15 Gy到LAD区域（V15）的平均值±标准差为10.48±13.04%，con - vmat为30.28±23.56%。与convo - vmat相比，DSA-VMAT显著改善LAD区V15 （p=0.01）。此外，DSA-VMAT显著降低心脏平均剂量（8.64±5.37 Gy比11.23±7.37 Gy）、心脏V40（17.55±4.76%比20.44±6.06%）、肺V20（14.87±5.93%比17.81±7.70%）、肺V5(57.27±8.24%比61.15±9.97%)（均p≤0.01）。相比之下，两组在PTV剂量覆盖率[D95 (p=0.61), D50 (p=0.62)]和符合性指数（p=0.91）方面无显著差异。结论：与convv - vmat相比，DSA-VMAT改善了LAD区域的剂量分布，但不影响PTV剂量覆盖。因此，DSA-VMAT可以在不丧失疗效的情况下减少EC患者的辐射诱发心脏病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.