Dual Arc Volumetric-Modulated Arc Therapy for Cervical Cancer: A Dosimetric and Treatment Planning Comparison with 9 Fields Intensity-Modulated Radiotherapy Technique

Objectives: Finding the most efficient option for therapy for patients with cervical cancer was the goal of this study, which compared and examined the plan quality of IMRT and VMAT procedures using various kinds of dosimetric indices. Methods: The study considered 13 patients retrospectively who were previously treated using sliding window IMRT techniques during September 2023 to July 2024. IMRT and VMAT plans were compared in terms of target coverage, organs at risk (OARs), homogeneity index (HI), conformity index (CI), gradient index (GI), Unified Dosimetry Index (UDI), conformation number (CN), integral dose (ID), the number of monitor units (MUs) and treatment time (s). Findings: The target coverage (p<0.001), CI (p=0.001), HI (p=0.009), GI (p=0.042) and CN (p<0.001) and UDI(p=0.006) in all parameters VMAT plan was superior to the IMRT plan. The better OARs sparing and significantly reduced MUs (p<0.001), treatment time (p<0.001) and ID (p<0.001) with VMAT was obtained in comparison to fixed field IMRT. Novelty: VMAT has the best performance in terms of target coverage, CI, HI, GI, CN and UDI and can better protect the OARs. VMAT plans have fewer MUs and improve treatment efficiency. Keywords: Cervical cancer, Radiotherapy, Intensity-Modulated Radiation Therapy, Volumetric Modulated Arc Therapy, Integral Dose, Homogeneity Index