Volume 11,Issue 5
Comparison of Clinical Efficacy of Two Image-Guided Localization Techniques in Intensity-Modulated Radiotherapy for Advanced Non-Small Cell Lung Cancer
Objective: To compare the clinical efficacy of image-guided localization techniques using three-dimensional cone-beam computed tomography (3D-CBCT) versus four-dimensional cone-beam computed tomography (4D-CBCT) in intensity-modulated radiation therapy (IMRT) for advanced non-small cell lung cancer (NSCLC), providing a reference for selecting optimal radiotherapy localization techniques. Methods: A total of 86 patients with advanced NSCLC admitted to our hospital from January 2023 to December 2024 were enrolled as study subjects and divided into a control group (3D-CBCT guidance, n = 43) and an observation group (4D-CBCT guidance, n = 43) based on the imaging-guided localization technique employed. All patients received IMRT treatment. The positioning errors, target dose distribution, normal tissue exposure doses, short-term clinical outcomes, and incidence of adverse radiation effects were compared between the two groups. Results: The X-, Y-, and Z-axis translation positioning errors and rotational positioning errors in the observation group were significantly lower than those in the control group (p < 0.05). The conformity index (CI) and uniformity index (HI) of the target volume in the observation group were significantly superior to those in the control group, and the planned target volume (ITV) was smaller (p < 0.05). The radiation doses to critical organs such as the lungs, heart, and esophagus were significantly lower in the observation group (p < 0.05). There was no significant difference in short-term objective response rates between the two groups (p > 0.05); however, the overall incidence of adverse reactions such as radiation pneumonitis and radiation esophagitis was significantly lower in the observation group (p < 0.05). Conclusion: Compared with 3D-CBCT, the image-guided localization technique using 4D-CBCT in IMRT treatment for advanced NSCLC patients can effectively reduce positioning errors, optimize target dose distribution, minimize radiation damage to normal tissues, enhance radiotherapy safety, and demonstrate greater clinical value.
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