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For patients receiving radiotherapy for locally advance non–small cell lung cancer ( NSCLC ), the probability of experiencing severe radiation pneumonitis ( RP ) appears to rise with an increase in radiation received by the lungs. Intensity modulated radiotherapy ( IMRT ) provides the ability to reduce planned doses to healthy organs at risk ( OAR ) and can potentially reduce treatment‐related side effects. This study reports toxicity outcomes and provides a dosimetric comparison with three‐dimensional conformal radiotherapy ( 3DCRT ).    Methods  Thirty curative  NSCLC  patients received radiotherapy using four‐dimensional computed tomography and five‐field  IMRT . All were assessed for early and late toxicity using common terminology criteria for adverse events. All plans were subsequently re‐planned using  3DCRT  to the same standard as the clinical plans. Dosimetric parameters for lungs, oesophagus, heart and conformity were recorded for comparison between the two techniques.    Results   IMRT  plans achieved improved high‐dose conformity and reduced  OAR  doses including lung volumes irradiated to 5–20 Gy. One case each of oesophagitis and erythema (3%) were the only Grade 3 toxicities. Rates of Grade 2 oesophagitis were 40%. No cases of Grade 3  RP  were recorded and Grade 2  RP  rates were as low as 3%.    Conclusion   IMRT  provides a dosimetric benefit when compared to  3DCRT . While the clinical benefit appears to increase with increasing target size and increasing complexity,  IMRT  appears preferential to  3DCRT  in the treatment of  NSCLC .

journal of medical radiation sciences

Toxicity and dosimetric analysis of non–small cell lung cancer patients undergoing radiotherapy with 4DCT and image‐guided intensity modulated radiotherapy: a regional centre's experience