Lattice Radiotherapy: A Comparative Feasibility Study of IMRT with VMAT
DOI:
https://doi.org/10.29384/rbfm.2025.v19.19849001769Keywords:
Lattice, Radiotherapy, VMAT, IMRT, SFRTAbstract
The comparative study included ten neoplasia cases planned with IMRT, contrasted with VMAT plans previously studied in the institution. The Lattice Spatially Fractionated Radiation Therapy technique was applied in the initial fraction, prescribing 5 Gy to the target volume and 14 Gy to spheres within the GTV, followed by four additional fractions of 5 Gy homogeneous in the target. The study revealed greater difficulty in conforming the prescribed dose to peaks, evidenced by the conformity index variation, averaging 1.85 ± 0.27 for IMRT and 1.19 ± 0.24 for VMAT. The analysis indicated a +4.1% discrepancy in the average dose at peaks and a 3.7 ratio in MUs. Although both met quality criteria in gamma evaluation, IMRT's beam-on time was 3.6 times longer than VMAT. The analysis of OAR doses suggests comparability between approaches. This study emphasizes the potential equivalence between SFRT with the Lattice technique using IMRT versus VMAT. It concludes that both have peculiarities, with the choice based on clinical needs, treatment efficiency, and technology availability. The increase in MUs and beam-on time were IMRT's main limitations, but its efficacy in preserving critical organs was highlighted, reinforcing the safety and personalization of radiotherapeutic treatment with IMRT in the application of the Lattice technique.
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