Reduction of oesophageal toxicity with VMAT dose-sparing radiotherapy in thoracic metastatic spinal cord compression: A feasibility study

Gram, V.; Gram, Daniel; Persson, G.; Suppli, Morten Hiul; Barrett, Sarah

doi:10.1016/j.tipsro.2022.07.001

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…Remberg Gram and co-workers demonstrated the feasibility of VMAT in sparing the esophagus in a planning study on 29 pts with metastatic spinal cord compression (MSCC) [30]. In an ongoing clinical trial, a prospective cohort of 65 pts with MSCC is being treated with VMAT (or SBRT in pts with single spinal metastases) with 18 × 2.33 Gy [31].…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of Conventional Radiotherapy, Volumetric Modulated Arc Therapy, and Proton Beam Therapy for Palliation of Thoracic Spine Metastases Secondary to Breast or Prostate Cancer

Lideståhl,

Fredén,

Siegbahn

et al. 2023

Cancers

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The aim of this planning study was to compare the dosimetric outcomes of Volumetric Modulated Arc Therapy (VMAT), Proton Beam Therapy (PBT), and conventional External Beam Radiation Therapy (cEBRT) in the treatment of thoracic spinal metastases originating from breast or prostate cancer. Our study utilized data from 30 different treatment plans and evaluated target coverage and doses to vital organs at risk (OARs), such as the spinal cord, heart, esophagus, and lungs. The results showed that VMAT and PBT achieved superior target coverage and significantly lower doses to the spinal cord compared to cEBRT (target: median PTVD95%: 75.2 for cEBRT vs. 92.9 and 91.7 for VMAT (p < 0.001) and PBT (p < 0.001), respectively; spinal cord: median Dmax%: 105.1 for cEBRT vs. 100.4 and 103.6 for VMAT (p < 0.001) and PBT (p = 0.002), respectively). Specifically, VMAT was notable for its superior target coverage and PBT for significantly lower doses to heart, lungs, and esophagus. However, VMAT resulted in higher lung doses, indicating potential trade-offs among different techniques. The study demonstrated the relative advantages of VMAT and PBT over traditional RT in the palliative treatment of spinal metastases using conventional fractionation. These findings underscore the potential of VMAT and PBT to improve dosimetric outcomes, suggesting that they may be more suitable for certain patient groups for whom the sparing of specific OARs is especially important.

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Section: Discussionmentioning

confidence: 99%