The efficiency of Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) in bone marrow of lumber spinal cord tumor radiotherapy

Abstract

Author(s): Dania Dhafer Hameed, Vyan Hussein Abdulhakeem, Sura AbdulKareem Madlool, Nabaa Mohammed Ali, Duaa Ali Salih and Fatima Jassim Mohammed

Background: This study aimed to assess and contrast the efficacy of two approaches for planning treatment, namely IMRT and VMAT, for individuals who suffer from spinal cord tumors that have metastasized from other body regions. Materials and Methods: This study involved 60 randomly selected patients with vertebral spinal cord bone cancerous tumors. The study compared the use of two treatment planning techniques, IMRT and VMAT, using the MONACO 5.1 Treatment Planning System (TPS) and ELEKTA's Agility linear accelerator. A prescribed dose of 20 Gy per 5 fractions was set for the study. Both IMRT and VMAT planning techniques were used, and the maximum iteration of calculations was limited to 500 times. The study evaluated the dose Homogeneity (HI) and the Conformity Index (CI) of the two planning techniques. Results: The results show that males have a higher mean age than females. The study found that the prevalence of female patients was slightly higher than that of males. Moreover, the mean weight of females is significantly higher than that of males. The VMAT provided better coverage than IMRT regarding PTV coverage at 95% of the prescribed dose. The hot area, of 105%, was also significantly more delivered by VMAT than by IMRT. However, there was no significant difference between VMAT and IMRT in the cold area. The VMAT plans had significantly better homogeneity and conformity indexes than the IMRT plans. VMAT provided better protection for the spinal cord and lower maximum and minimum dose delivery for both kidneys compared to IMRT. As the kidneys are sensitive to radiation, VMAT may be preferable for spinal cord protection and kidney sparing. Conclusion: The study suggests that VMAT may improve treatment outcomes and reduce the risk of tumor recurrence. However, further research is needed to confirm these findings and evaluate the long-term clinical outcomes of these treatment techniques. This study shows VMAT to be promising in reducing radiation dose to OARs, indicating that it may provide superior OARs protection compared to IMRT for these patients.

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