%0 Case Reports
%T Early-stage central lung cancer and volumetric modulated arc therapy: a dosimetric case study with literature review.
%A Valakh V
%A Chan P
%A D'Adamo K
%A Micaily B
%J Anticancer Res
%V 33
%N 10
%D Oct 2013
%M 24123020
%F 2.435
%R 
%X <B>OBJECTIVE: </B>In the present article we review on the use of Volumetric Modulated Arc Therapy (VMAT) for a small lung nodule that was centrally located in close proximity to the mediastinal structures.<BR><B>METHODS: </B>An inoperable patient with central, clinical stage IA adenocarcinoma of the right lung was treated with external-beam radiation therapy of 52.5 Gy in 15 factions. A single 360° coplanar arc VMAT plan (360-VMAT) was used for treatment and compared to step-and-shoot Intensity Modulation Radiotherapy (IMRT) and a single 180° ipsilateral partial arc VMAT plan (180-VMAT).<BR><B>RESULTS: </B>Planning Target Volume (PTV) coverage was not different, and 360-VMAT had the highest dose homogeneity. Both 360-VMAT and 180-VMAT reduced esophageal dose compared to IMRT. While IMRT had the lowest lung dose, all 3 plans achieved acceptable sparing of the lung. 180-VMAT had the highest dose conformity. Both 360-VMAT and 180-VMAT improved esophageal sparing compared to IMRT.<BR><B>CONCLUSIONS: </B>Use of VMAT in early-stage, centrally located NSCLC is a promising treatment approach and merits additional investigation.