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<p>This study evaluated the feasibility of a novel dynamic conformal arc therapy (DCAT) plan, based on segment shape optimization (SSO) and variable dose rate (VDR), versus volumetric modulated arc therapy (VMAT) for stereotactic body radiotherapy (SBRT) in stage I/II centrally located non-small-cell lung cancer (NSCLC) per RTOG 0813. Twenty-five patients with PTV &lt; 70&#xa0;cc were retrospectively analyzed, with both plans using identical parameters in Monaco. Both plans met RTOG 0813 criteria. DCAT showed increased ipsilateral and total lung dose but no significant differences in most other organs at risk (OARs) (<Emphasis Type="BoldItalic">P</Emphasis> &gt; 0.05). DCAT significantly reduced segments (median 19.38%), monitor units (MUs, median 23.27%), and beam-on time (BOT, median 8.80&#xa0;s; <Emphasis Type="BoldItalic">P</Emphasis> &lt; 0.05). Its γ passing rate (2%, 1&#xa0;mm) was higher (93.70% vs. VMAT 91.90%, <Emphasis Type="BoldItalic">P</Emphasis> &lt; 0.05). Larger PTV volumes improved DCAT’s heterogeneity index (HI) and segment advantages but worsened R<sub>50%</sub> vs. VMAT. Novel DCAT is feasible for SBRT in such NSCLC, especially with small PTV, offering shorter BOT, higher delivery accuracy, and comparable OARs sparing to VMAT.</p>

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Novel DCAT plans in stereotactic body radiotherapy for stage I/II centrally located non-small-cell lung cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月14日

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  • Yangyang Huang,
  • Jun Yang,
  • Cheng Wang,
  • Jinghui Yang,
  • Ge Hou,
  • Chengzhang Long,
  • Yibao Liu

摘要

This study evaluated the feasibility of a novel dynamic conformal arc therapy (DCAT) plan, based on segment shape optimization (SSO) and variable dose rate (VDR), versus volumetric modulated arc therapy (VMAT) for stereotactic body radiotherapy (SBRT) in stage I/II centrally located non-small-cell lung cancer (NSCLC) per RTOG 0813. Twenty-five patients with PTV < 70 cc were retrospectively analyzed, with both plans using identical parameters in Monaco. Both plans met RTOG 0813 criteria. DCAT showed increased ipsilateral and total lung dose but no significant differences in most other organs at risk (OARs) (P > 0.05). DCAT significantly reduced segments (median 19.38%), monitor units (MUs, median 23.27%), and beam-on time (BOT, median 8.80 s; P < 0.05). Its γ passing rate (2%, 1 mm) was higher (93.70% vs. VMAT 91.90%, P < 0.05). Larger PTV volumes improved DCAT’s heterogeneity index (HI) and segment advantages but worsened R50% vs. VMAT. Novel DCAT is feasible for SBRT in such NSCLC, especially with small PTV, offering shorter BOT, higher delivery accuracy, and comparable OARs sparing to VMAT.