Comparisons between the Dosimetric and Clinical Outcomes of Tomotherapy and 3D Conformal Radiotherapy in Gastric Cancer Treatment

Document Type : Research Articles


1 Consultant Oncologist, University of Health Sciences, Kanuni Research and Training Hospital, Dept of Radiation Oncology, Trabzon, Turkey.

2 Medical Physicist MSc, Yildirim Beyazit University, Medical School, Ataturk Research and Training Hospital, Department of Radiation Oncology, Ankara, Turkey.

3 Professor of Public Health, Karadeniz Technical University, Medical School, Department of Public Health, Trabzon Turkey.

4 Associate Professor of Surgery, Bahcesehir University, Medical School, Department of General Surgery, Istanbul, Turkey.

5 Associate Professor of Surgery, Karadeniz Technical University, Medical School, Trabzon, Turkey.

6 Professor of Surgery, University of Health Sciences, Kanuni Research and Training Hospital Department of General Surgery, Trabzon, Turkey.


Introduction: Previous studies comparing tomotherapy (TOMO) and three dimensional (3D) conformal radiotherapy
(3DCRT) in gastric radiotherapy are limited and tend to be based on dosimetry. The aim of the present study was to
evaluate the clinical outcomes of these two treatment modalities. Methods: A total of 51 patients diagnosed with gastric
cancer who were treated with postoperative adjuvant chemoradiotherapy and had subtotal/total gastrectomy and D2
lymphatic dissection were recruited to the present study: 30 patients were treated with TOMO and 21 patients were
treated with 3DCRT. Results: The 3DCRT and TOMO treatment regimens were compared. There was no difference in
planning target volume (PTV) 95%, but TOMO was statistically significant in regard to PTV 105% (P<0.05). TOMO
was also significantly different when compared with 3DCRT when evaluating liver mean dose, liver V40, right/left
kidneys mean dose, right/left kidneys V20 and spinal cord mean dose values (P<0.05). Grade 2 acute side effects were
more frequent (85.7%) following 3DCRT. In addition, the median overall survival time for TOMO treated patients
was 62 months while in 3DCRT treated patients it was 22.05 months. The difference in disease free survival was also
significantly increased in patients treated with TOMO (66.7% vs. 19.0%; P<0.05). Conclusion: TOMO treatment
resulted in lower acute side effects with better patient survival following gastric cancer radiotherapy.


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