Dosimetric and toxicity comparison of IMRT and 3D-CRT of non-small cell lung cancer

Purpose - Although three-dimensional conformal radiotherapy (3D-CRT) remains the gold standard asa curative treatment for NSCLC when surgery is not possible, intensity modulated radiotherapy (IMRT) is increasingly used routinely. The purpose of this study was to assess the clinical (immediate toxicities) and dosimetric impact of IMRT compared to 3D-CRT in the treatment of locally advanced (stages IIIA toIIIC) non-small cell lung cancer (NSCLC) treated with concomitant radiochemotherapy, while IMRT inlung cancer was implemented in the radiotherapy department of the Jean-Perrin Center. Patients and methods. - Between March 2015 and October 2019, 64 patients treated with concomitant radiochemotherapy were retrospectively included. Thirty-two received 3D-CRT and 32 IMRT. Theradiotherapy prescription was 66 Gy in 33 fractions of 2 Gy. Results. - IMRT has improved coverage of target volumes (V95 increased by 14.81% in IMRT; P < 0.001) without increasing doses to OARs and reducing dysphagia (RR = 0.67; P = 0.027). Low doses to the lungwere not significantly increased in IMRT (pulmonary V5 increased by 7.46% in IMRT). Conclusion. - Intensity modulated radiotherapy, compared with the standard RC3D technique, improvethe coverage of target volumes without increasing the dose to the OARs. It also improves the immediatetolerance of the treatment by reducing the number of dysphagia. (c) 2021 Published by Elsevier Masson SAS on behalf of Societe francaise de radiotherapie oncologique (SFRO).

Automated summary

IMRT improves target volume coverage compared to 3D-CRT in the treatment of NSCLC, without increasing doses to organs at risk and reducing dysphagia.