Affiliation:
1. Department of Radiological Physics and Bio-Engineering, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
2. Department of Clinical Pharmacology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
3. Department of Blood Transfusion and Immunohematology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
Abstract
ABSTRACT
Objective:
This study aims to evaluate the radiobiological benefits among the different radiotherapy (RT) planning techniques for esophageal squamous cell carcinoma (ESCC).
Materials and Methods:
In this experimental study, 35 patients with ESCC cancer were planned for the field-in-field (FIF), three fields (3Fs), and four-field boxes were performed for each patient for a 6 MV photon beam. The parameters of the conformity index (CI), homogeneity index (HI), Dmean, Dmax, tumor control probability (TCP), V20Gy, and V30Gy of the heart and lungs, and normal tissue complication probability (NTCP) were analyzed to evaluate treatment plans. Dose distribution in the target volume, the monitor units (MUs) required, and the dose delivered to organs at risk (OARs) were compared for these techniques using the paired-sample t-test.
Results:
A significant difference was measured between the FIF, 3F, and 4F techniques with respect to CI, dose HI, and TCP for the target organ, as well as the Dmean for the heart and liver. For the spinal cord, the FIF technique showed a slight reduction in the maximum dose compared to the other two techniques. In addition, the V20Gy of the lungs and the NTCP of all OARs were reduced with the FIF method.
Conclusion:
The FIF technique showed better performance in terms of dose homogeneity in the target, conformity of the radiation field with the target volume, TCP, less dose to healthy organs, and fewer MU, which could improve the TCP and spare the heart, lungs, and spinal cord. Our study provides a prediction of RT outcomes and further guides the individual treatment.