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Comparison of acute toxicities between IMRT and VMAT in preoperative concurrent chemoradiotherapy for rectal cancer
Ren Hua, Jin Jing, Xiao Qin, Feng Yan-ru, Fang Hui, Li Ning, Wang Xin, Wang Weihu, Wang Shulian, Song Yongwen, Liu Yueping, Yu Zihao, Liu Xinfan, Dai Jianrong, Li Yexiong
Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
Abstract Objective To compare the acute toxicities and tolerance between static intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in the preoperative concurrent chemoradiotherapy for rectal cancer. Methods From 2006 to 2013, 242 rectal cancer patients received VMAT (n=61) or IMRT (n=181). The IMRT group was further divided into 7-field IMRT subgroup (n=44) and simplified IMRT (sIMRT) subgroup (n=137). All patients received preoperative radiotherapy to the pelvis at a dose of 50 Gy/25 fractions in 5 weeks, concurrently with capecitabine (1650 mg/m2/day) and oxaliplatin (50 mg/m2/week) for 5 weeks. Comparison between groups was made by grouped t test. Results Nineteen (7.9%) of all patients discontinued radiotherapy due to toxicities, with 4.9% in VMAT group and 8.8% in IMRT group (P=0.325);also, no significant difference in the incidence of toxicities was found between the 7-field IMRT and sIMRT subgroups (8.0% vs 11.4%, P=0.498). The most common acute toxicities in all patients were leucopenia (69.4%, grade ≥3 5.8%), diarrhea (65.5%, grade ≥3 20.7%), and radiodermatitis (62.0%, grade ≥3 7.9%). There were no significant differences in the incidence of most common acute toxicities between the VMAT and IMRT groups (68.9% vs 69.6%, P=0.911;63.9% vs 67.4%, P=0.620;65.6% vs 60.8%, P=0.504), but the VMAT group had a significantly lower incidence of weight loss than the IMRT group (3.3% vs 12.7%, P=0.036). The incidence of most common acute toxicities showed no significant differences between the 7-fieldIMRT and sIMRT subgroups (65.9% vs 70.8%, P=0.539;63.6% vs 68.6%, P=0.540;59.1% vs 61.3%, P=0.793). Among grade ≥3 toxicities, vomiting occurred less frequently in the sIMRT subgroup than in the 7-field IMRT subgroup (0 vs 6.8%, P=0.002). Conclusions For patients with rectal cancer, IMRT and VMAT in preoperative concurrent chemoradiotherapy are well tolerable and lead to similar incidence of acute toxicities. The differences in certain adverse reactions between 7-field IMRT and sIMRT need to be investigated.
Ren Hua,Jin Jing,Xiao Qin et al. Comparison of acute toxicities between IMRT and VMAT in preoperative concurrent chemoradiotherapy for rectal cancer[J]. Chinese Journal of Radiation Oncology, 2014, 23(3): 205-209.
Ren Hua,Jin Jing,Xiao Qin et al. Comparison of acute toxicities between IMRT and VMAT in preoperative concurrent chemoradiotherapy for rectal cancer[J]. Chinese Journal of Radiation Oncology, 2014, 23(3): 205-209.
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2014, Vol. 23 
