Online ISSN: 2515-8260

Dosimetric analysis of VMAT Irradiation in Nasopharyngeal Carcinoma: A Moroccan Radio Oncology Center's experience

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Bouchra Amaoui1*, Slimane Semghouli2 , Dounia Mouhssine3 , Abdelaziz Bayla3 , abdellatif Bouih3 , Nawal Bouih3 , Hicham Tamri3 , Mohamed El Mourchid3 , and Noureddine Benjaafar

Abstract

Introduction: Volumetric Modulated Arc Therapy (VMAT) is a technique increasingly used in radiotherapy. It was recently introduced in Morocco. Furthermore, technological advances allow the use of conformal radiotherapy to be phased out and replaced by VMAT technique for some locations. This study aims to evaluate the efficacy and quality of treatment with VMAT of nasopharyngeal cancer. Methods: Twenty patients with non-metastatic nasopharyngeal cancer treated curatively by VMAT were studied at the Al Kindy Oncology Center in Casablanca. The dose was delivered using two arcs at a dose of 70 Gy in 35 fractions. The optimization process was performed using the photon optimizer (PO) algorithm, which is available from versions 13.5.35 and beyond of the Varian Eclipse radiotherapy treatment planning system (Varian Medical Systems, Palo Alto, CA). Dosimetric data were collected from dose-volume histograms for target volumes (PTV) and organs at risk (OARs). The homogeneity index (HI) and the conformity index (CI) were calculated. The acute and late toxicities associated with radiotherapy were observed, and the evolution and follow-up of patients were carried out. Results: For high risk (HR), intermediate risk (IR), and low risk (LR) PTVs, the D95% was (95.54±1.61), (103.00±1.66) and (100.00±1.90)%, respectively, while the D2% was (105.15±1.11), (105.20±1.42) and (104.56 ±1.25)%, respectively. For HR PTV, CI and HI were (0.98 ± 0.02) and (0.12 ± 0.03), respectively. For late toxicity, there were no reports of grade IV toxicity or grade III xerostomia. In contrast, a drop in the hearing of grade III was reported in 10% of patients. Patients' evolution was marked by a locoregional recurrence rate of 15% and a specific death rate of 20%. Conclusion: The VMAT technique allows an excellent coverage of the target volumes while sparing the OARs particularly the nerve structures and the salivary glands

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