3DCRT Versus RapidArc in Terms of Iso-Dose Distribution, Dose Volume Histogram (DVH) and Organs at Risk for Esophageal Cancer (EC) Dosimetric Study

Abstract

Purpose: To compare (3D-CRT) to RapidArc planning using (LNAC of 6 MV) in terms of dosimetric outcomes of iso-dose distribution, dose volume histogram (DVH), PTV and at risk organs in 5 patients with Esophageal cancer (EC). Methods: Plans were created for 5 patients with EC who had received radical RapidArc treatment from 2012 to 2014 at KAMC (King Abdullah Medical City). Results: RapidArc plan showed a more homogeneous dose distribution in PTV, achieving an HI of 1.112 ± 0.030 compared with 1.096 ± 0.029 in the 3D-CRT plan. However, RapidArc and 3D-CRT achieved nearly equal in both modalities with average value of (0.130 ± 0.052) in RapidArc compared to (0.134 ± 0.054) in 3D-CRT, (p = 0.061) in terms of CI values and Target coverage index (TCI) was (0.093 ± 0.032) in RapidArcand and (0.099 ±0.058) in 3D-CRT, (p = 0.767). Additionally, regarding OARs, the mean and maximum dose in Spinal Cord was lower in RapidArc with a low percentage of the volume receiving low doses. Left and Right Lungs were within tolerance in RapidArc and 3D-CRT. RT. Kidney was lower in RapidArc, while LT Kidney was lower in 3D-CRT. For Heart, the maximum dose was within tolerance criteria in RapidArc but exceeded the criteria in 3D-CRT at 60.97 Gy. For the spinal cord, the maximum dose was notably low and did not exceed 1.91 Gy in RapidArc, while it exceeded the acceptable limit in 3D-CRT. Conclusions: (VMAT) is superior to 3D-CRT in term of PTV, conformity and homogeneity. This study suggests that VMAT class solution is the superior treatment option.