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Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma

  • Authors:
    • Zhanquan Lei
    • Junjie Jing
    • Yuequan Shi
    • Bo Gao
    • Kongfeng Shao
    • Yiqun Liu
    • Junjin Yan
  • View Affiliations / Copyright

    Affiliations: Department of Radiotherapy, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fuzhou, Fujian 350014, P.R. China, Department of Neurosurgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), Fuzhou, Fujian 350014, P.R. China, Department of Radiology, Fujian Provincial Maternity and Children's Hospital, Fuzhou, Fujian 350010, P.R. China
    Copyright: © Lei et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 544
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    Published online on: September 22, 2025
       https://doi.org/10.3892/ol.2025.15290
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Abstract

The present study aimed to compare the dosimetric characteristics of non‑coplanar (NC) and coplanar volumetric modulated arc therapy (VMAT) in the treatment of pediatric brainstem glioma, to inform clinical decision‑making and improve therapeutic strategies. A retrospective analysis was performed on 10 pediatric patients diagnosed with brainstem glioma who received radiotherapy at Department of Radiotherapy, Fujian Children's Hospital (Fuzhou, China). Using the Eclipse 15.5 treatment planning system, both coplanar VMAT and NC‑VMAT plans were generated for each patient. Key dosimetric parameters, including the conformity index (CI), homogeneity index (HI), dose to organs at risk, γ passing rate and treatment time, were compared between the two planning approaches. Compared with standard VMAT, NC‑VMAT demonstrated significantly improved dosimetric performance in target coverage, with superior CI (1.045±0.003 vs. 1.095±0.010; P<0.01) and HI (0.066±0.003 vs. 0.849±0.004; P<0.001). NC‑VMAT also resulted in significantly reduced radiation doses to critical structures, including the left (L) and right (R) lenses (lens‑L: 2.89±0.30 Gy vs. 4.13±0.40 Gy; lens‑R: 2.94±0.27 Gy vs. 4.07±0.32 Gy; P<0.05), cochleae (cochlea‑L: 35.20±1.97 Gy vs. 42.03±2.21 Gy; cochlea‑R: 36.71±1.64 Gy vs. 42.18±1.54 Gy; P<0.001) and optic chiasm (45.11±0.62 Gy vs. 50.63±0.40 Gy; P<0.05). However, standard VMAT showed better sparing of the temporal lobes (TLs) (TL‑L: 19.77±1.55 Gy vs. 24.91±0.88 Gy; TL‑R: 19.61±1.44 Gy vs. 24.77±0.86 Gy; P<0.005) and normal brain tissue (13.98±0.10 Gy vs. 15.40±0.17 Gy; P<0.001). In conclusion, NC‑VMAT demonstrates clear dosimetric advantages in the radiotherapeutic management of pediatric brainstem gliomas. These findings may contribute meaningfully to improving the precision, safety and clinical outcomes of radiotherapy for children affected by this challenging condition.
View Figures

Figure 1

Schematic illustration of a
non-coplanar irradiation field. (A) The radiation beam paths from a
three-dimensional spatial perspective. (B) Distribution path of the
beams relative to the target volume on a specific imaging
plane.

Figure 2

Comparison of dose coverage on the
same level between two different plans: VMAT and NC-VMAT. NC-VMAT,
non-coplanar volume-modulated arc therapy.

Figure 3

Radiation dose comparison of OARs
between VMAT and NC-VMAT treatment plans. ***P<0.001,
**P<0.01 and *P<0.05. NC-VMAT, non-coplanar volume-modulated
arc therapy; L, left; R, right; OAR, organs at risk.
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Copy and paste a formatted citation
Spandidos Publications style
Lei Z, Jing J, Shi Y, Gao B, Shao K, Liu Y and Yan J: Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma. Oncol Lett 30: 544, 2025.
APA
Lei, Z., Jing, J., Shi, Y., Gao, B., Shao, K., Liu, Y., & Yan, J. (2025). Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma. Oncology Letters, 30, 544. https://doi.org/10.3892/ol.2025.15290
MLA
Lei, Z., Jing, J., Shi, Y., Gao, B., Shao, K., Liu, Y., Yan, J."Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma". Oncology Letters 30.6 (2025): 544.
Chicago
Lei, Z., Jing, J., Shi, Y., Gao, B., Shao, K., Liu, Y., Yan, J."Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma". Oncology Letters 30, no. 6 (2025): 544. https://doi.org/10.3892/ol.2025.15290
Copy and paste a formatted citation
x
Spandidos Publications style
Lei Z, Jing J, Shi Y, Gao B, Shao K, Liu Y and Yan J: Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma. Oncol Lett 30: 544, 2025.
APA
Lei, Z., Jing, J., Shi, Y., Gao, B., Shao, K., Liu, Y., & Yan, J. (2025). Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma. Oncology Letters, 30, 544. https://doi.org/10.3892/ol.2025.15290
MLA
Lei, Z., Jing, J., Shi, Y., Gao, B., Shao, K., Liu, Y., Yan, J."Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma". Oncology Letters 30.6 (2025): 544.
Chicago
Lei, Z., Jing, J., Shi, Y., Gao, B., Shao, K., Liu, Y., Yan, J."Retrospective comparisons of the dosimetric differences between coplanar and non‑coplanar volume‑modulated arc therapy in patients with pediatric brainstem glioma". Oncology Letters 30, no. 6 (2025): 544. https://doi.org/10.3892/ol.2025.15290
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