ORIGINAL RESEARCH article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1443226
Thyroid-sparing volume-modulated arc therapy in patients with non-distant metastatic nasopharyngeal carcinoma：a feasibility study
Provisionally accepted
- Depatment of Radiation Oncology, Cancer Hospital, College of Medicine, Shantou University, Shantou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Purpose: To assess the dosimetric feasibility of thyroid-sparing volume-modulated arc therapy (TS VMAT) in patients with non-distant metastatic nasopharyngeal carcinoma.Methods: TS VMAT plans and non-thyroid-sparing volume-modulated arc therapy (NTS VMAT) plans were created using inverse-planning VMAT and computed tomography datasets of 60 patients from two centers using the Eclipse version 15.6 treatment planning system. These patients were split up into three groups, each consisting of ten patients: the bilateral upper neck irradiation group, the one-side lower neck irradiation group, and the bilateral lower neck irradiation group. Dose volume histograms, the homogeneity index (HI), conformity index (CI), and irradiation doses to the thyroid and other OARs were used to assess the two treatment plans.Results: There were no statistically significant differences in HI, CI, and dosage distribution to OARs between the two plans, except for the bilateral lower neck irradiation group, where mild but clinically acceptable differences were observed. Surprisingly, the TS VMAT plans significantly reduced the radiation dose to the thyroid gland across all three groups without compromising target coverage, conformity, or dose homogeneity. Specifically, the mean dose to the thyroid was substantially lower in the TS VMAT plans compared to the NTS VMAT plans.Additionally, the volume of the thyroid irradiated with 40 Gy or more was also significantly reduced in the TS VMAT plans.The TS VMAT plan is appropriate for radiotherapy planning in patients with non-distant metastatic nasopharyngeal carcinoma. The TS VMAT plan reduces radiation dosage to the thyroid gland compared to the NTS VMAT plan, lowering the risk of hypothyroidism without exacerbating the HI, CI, and the irradiation doses to OARs.
Keywords: nasopharyngeal carcinoma, Volume-modulated arc therapy (VMAT), thyroid, Hypothyroidism, Radiotherapy, Dosimetric feasibility
Received: 03 Jun 2024; Accepted: 27 May 2025.
Copyright: © 2025 XIE, Lu, Cai, Chen, Huang, Xie, Chen and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chuangzhen Chen, Depatment of Radiation Oncology, Cancer Hospital, College of Medicine, Shantou University, Shantou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.