【Objective】 To compare the dose distribution between three-dimensional conformal radiotherapy (3DCRT)

static intensity-modulated radiotherapy (sIMRT)

and volumetric modulated arc therapy (VMAT) for hepatocellular carcinoma. 【Methods】The 4DCT scans of 20 patients with hepatocellular carcinoma in right lobe were selected for this comparative analysis. The 3DCRT

IMRT

and VMAT plans were prepared for each patient. Dose prescription was 50 Gy to the planning target volume (PTV) in 25 fractions. PTV dose coverage

organs at risk (OAR) doses

monitor units (MU)

and treatment delivery parameters were assessed. 【Results】 All three plans achieved comparable Dmax. Both VMAT and IMRT showed significantly better PTV coverage

conformity

and homogeneity than 3DCRT. The mean dose to normal liver was as follows: (20.5 ± 4.5) Gy for 3DCRT

(21.1 ± 3.8) Gy for IMRT

and (20.9 ± 3.9) Gy for VMAT. Comparable sparing of normal tissues including kidney

stomach

small intestine and spinal cord were achieved with all three plans. The number of MU/fraction was 405 ± 99 for 3DCRT

392 ± 81 for IMRT

and 438 ± 76 for VMAT (P = 0.226). Effective treatment times for 3DCRT

IMRT and VMAT were (2.1 ± 0.2) min

(4.8 ± 0.7) min

and (3.0 ± 0.2) min

respectively (P = 0.000). 【Conclusion】 VMAT improved delivery efficiency for equivalent dosimetric quality as IMRT. Compared with 3DCRT

IMRT and VMAT provided favorable tumor coverage

but both IMRT and VMAT were not superior to 3DCRT in terms of normal tissues protection.