CAJ | 학술논문

Objective The aiom of the study was to compare the impacts of two types of multileaf col imators (MLC) [standard MLC with a width of 10 mm (sMLC) and micro-MLC with a width of 5 mm (mMLC)] on volumetric modulated arc therapy (VMAT) planning for malignant pleural mesothelioma. Methods VMAT for ten patients with inoperable malignant pleural mesotheliomas was retrospectively planned with the sMLC and mMLC. Histogram-based dose-volume parameters of the planning target vol-ume (PTV) [conformity index (CI) and homogeneous index (HI)] and organs-at-risk were compared for VMAT plans with sMLC (sMLC-VMAT) and mMLC (mMLC-VMAT). Results The mMLC-VMAT plans were more ef icient (average delivery time: 2.67±1.49 min) than the sMLC-VMAT plans (average delivery time: 4.21 ± 2.03 min; P < 0.05). Moreover, compared to the sMLC plans, the mMLC plans demonstrated advantages in the dose coverage of the PTV (CI 0.75 ± 0.08 vs 0.73 ± 0.09; HI 1.09 ± 0.02 vs 1.10 ± 0.02), although the dif erence was not statistical y significant (P > 0.05). In addition, significant dose sparing in the fraction of the ipsilateral lung volume receiving > 20 Gy (V20; 54.72 ± 27.08 vs 58.52 ± 29.30) and > 30 Gy (V30; 42.74 ± 27.86 vs 46.86 ± 31.49) radiation, respectively, was observed for the mMLC plans (P < 0.05). Conclusion Comparing sMLC-VMAT and mMLC-VMAT not only demonstrated the higher ef iciency and better optimal target coverage of mMLC-VMAT, but also considerably improved the dose sparing of the ipsilateral lung in the VMAT plans for malignant pleural mesothelioma.