Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)

Currently, advanced RT techniques such as VMAT and HT are being developed to optimize tumor coverage while minimizing radiation exposure to the surrounding organs that are at risk. Despite their growing clinical use, comparative studies evaluating the dosimetric and radiobiological effects of these...

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Main Authors: Phanwadee Kasetthamrongrat, Rinwarat Phumsankhot, Aphidet Duangya, Anirut Watcharawipha, Wannapha Nobnop, Narongchai Autsavapromporn
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Biology
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Online Access:https://www.mdpi.com/2079-7737/14/5/529
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author Phanwadee Kasetthamrongrat
Rinwarat Phumsankhot
Aphidet Duangya
Anirut Watcharawipha
Wannapha Nobnop
Narongchai Autsavapromporn
author_facet Phanwadee Kasetthamrongrat
Rinwarat Phumsankhot
Aphidet Duangya
Anirut Watcharawipha
Wannapha Nobnop
Narongchai Autsavapromporn
author_sort Phanwadee Kasetthamrongrat
collection DOAJ
description Currently, advanced RT techniques such as VMAT and HT are being developed to optimize tumor coverage while minimizing radiation exposure to the surrounding organs that are at risk. Despite their growing clinical use, comparative studies evaluating the dosimetric and radiobiological effects of these modalities remain limited. In this study, A549, HeLa, and HepG2 cells were exposed to a single 2 Gy dose, using three RT techniques (3D-CRT, dual arc VMAT, and HT). Treatment plans were generated using a water phantom to ensure consistent target coverage and comparable dosimetric parameters across the techniques. Multiple radiobiological endpoints were assessed to evaluate the cellular responses. Although all three techniques yielded similar dosimetric parameters without statistically significant differences, the biological responses varied among the cell lines. Notably, VMAT and HT demonstrated superior tumor cell suppression compared to 3D-CRT. This was likely due to their enhanced dose conformity and modulation precision, which potentially led to improved tumor cell killing. These findings highlight the importance of integrating radiobiological assessments with physical dose metrics to inform the clinical application of advanced RT technologies. However, this study had several limitations. The use of a single radiation dose limited its clinical relevance, and the immediate post-irradiation assessments may not have captured delayed biological responses. Additionally, the small number of replicates may have reduced the study’s statistical power. Future studies incorporating dose fractionation schemes, time course analyses, and larger sample sizes are warranted to better simulate clinical conditions and further elucidate the radiobiological effects of advanced RT techniques.
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spelling doaj-art-92f73cf812eb46f897face97bc6b8eec2025-08-20T01:56:20ZengMDPI AGBiology2079-77372025-05-0114552910.3390/biology14050529Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)Phanwadee Kasetthamrongrat0Rinwarat Phumsankhot1Aphidet Duangya2Anirut Watcharawipha3Wannapha Nobnop4Narongchai Autsavapromporn5Medical Physics Program, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandMedical Physics Program, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDivision of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandCurrently, advanced RT techniques such as VMAT and HT are being developed to optimize tumor coverage while minimizing radiation exposure to the surrounding organs that are at risk. Despite their growing clinical use, comparative studies evaluating the dosimetric and radiobiological effects of these modalities remain limited. In this study, A549, HeLa, and HepG2 cells were exposed to a single 2 Gy dose, using three RT techniques (3D-CRT, dual arc VMAT, and HT). Treatment plans were generated using a water phantom to ensure consistent target coverage and comparable dosimetric parameters across the techniques. Multiple radiobiological endpoints were assessed to evaluate the cellular responses. Although all three techniques yielded similar dosimetric parameters without statistically significant differences, the biological responses varied among the cell lines. Notably, VMAT and HT demonstrated superior tumor cell suppression compared to 3D-CRT. This was likely due to their enhanced dose conformity and modulation precision, which potentially led to improved tumor cell killing. These findings highlight the importance of integrating radiobiological assessments with physical dose metrics to inform the clinical application of advanced RT technologies. However, this study had several limitations. The use of a single radiation dose limited its clinical relevance, and the immediate post-irradiation assessments may not have captured delayed biological responses. Additionally, the small number of replicates may have reduced the study’s statistical power. Future studies incorporating dose fractionation schemes, time course analyses, and larger sample sizes are warranted to better simulate clinical conditions and further elucidate the radiobiological effects of advanced RT techniques.https://www.mdpi.com/2079-7737/14/5/529radiotherapythree-dimensional conformal radiotherapy (3D-CRT)volumetric modulated arc therapy (VMAT)helical tomotherapy (HT)cancer cellstumor response
spellingShingle Phanwadee Kasetthamrongrat
Rinwarat Phumsankhot
Aphidet Duangya
Anirut Watcharawipha
Wannapha Nobnop
Narongchai Autsavapromporn
Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)
Biology
radiotherapy
three-dimensional conformal radiotherapy (3D-CRT)
volumetric modulated arc therapy (VMAT)
helical tomotherapy (HT)
cancer cells
tumor response
title Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)
title_full Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)
title_fullStr Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)
title_full_unstemmed Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)
title_short Comparison of Tumor Cell Responses to Different Radiotherapy Techniques: Three-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), and Helical Tomotherapy (HT)
title_sort comparison of tumor cell responses to different radiotherapy techniques three dimensional conformal radiotherapy 3d crt volumetric modulated arc therapy vmat and helical tomotherapy ht
topic radiotherapy
three-dimensional conformal radiotherapy (3D-CRT)
volumetric modulated arc therapy (VMAT)
helical tomotherapy (HT)
cancer cells
tumor response
url https://www.mdpi.com/2079-7737/14/5/529
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