Comparative Analysis of Halcyon IMRT and VMAT Plans with DMX IMRT Plans for Tongue Cancer

Introduction: To determine the most effective treatment plan for tongue cancers, a comparative analysis is being conducted between Intensity-Modulated Radiation Therapy (IMRT_D) plans on the Clinac DMX system and both Volumetric Modulated Arc Therapy (VMAT_H) and IMRT_H plans for Halcyon Elite machine.Material and Methods: A retrospective study was conducted on ۲۰ patients with tongue cancers. A total dose of ۶۰ Gy was delivered in two phases (i.e., ۵۰ Gy for Elective and ۱۰ Gy for Boost). All patients were treated using VMAT plans with unflattened beams from Varian Halcyon Elite (VMAT_H). For comparison, ۴۰ equivalent IMRT plans with unflattened and flattened beams were created for Varian Halcyon Elite and Varian Clinac DMX (IMRT_H and IMRT_D). Plan parameters such as Homogeneity, Conformity, and Gradient Indices, along with OAR doses, were compared across the three plans.Results: This study reveals that the HI of IMRT_H plans is significantly lower (P<۰.۰۵) compared to IMRT_D and VMAT_H plans. The CI and GI of IMRT_H and VMAT_H plans are significantly lower (P<۰.۰۵) than those of IMRT_D plans. VMAT_H plans and IMRT_H treatment plans achieve lower doses of OARs, showing a significant difference in statistics compared to IMRT_D plans. The Monitor Units required by VMAT_H plans are significantly lower (P<۰.۰۵) than those of IMRT_D and IMRT_H plans.Conclusion: Volumetric Modulated Arc Therapy planned with Halcyon Elite configuration is suggested for the treatment of patients with tongue cancers. VMAT_H and IMRT_H plans were similar in plan parameters and OAR sparing, but VMAT_H required fewer Monitor Units.

Keywords:

Flattened Beams Intensity , Modulated Radiotherapy Un , flattened Beams Volumetric , Modulated Arc Therapy Tongue Neoplasms