Abstract: Objective To compare the feasibility of using volumetric modulated arc therapy（VMAT） or static intensity-modulated radiotherapy（IMRT）to treat advanced esophageal neoplasm. Methods A consecutive series of 37 patients newly diagnosed with esophageal neoplasm was analyzed by computed tomography， and the resulting images were input into the oncentra planning system to generate protocols for IMRT and VMAT. All 37 patients received both types of treatment. Dose-volume histograms were generated to compare gross tumor volume（GTV），planning target volume（PTV） and exposure of at-risk organs. Different results for each method were assessed for statistical significance using the paired t-test. Results VMAT gave slightly but not significantly higher values than IMRT for PTV-D₉₈ （58.39±1.03 vs 58.51±0.57，P=0.314） and PTV-D2（65.92±1.57 vs 66.17±1.25，P=0.230）. VMAT was associated with significantly lower GTV D₉₈ （60.03±1.23 vs 62.46±1.03，P<0.001），D₂ （64.83±0.91 vs 66.08±1.01，P=0.001），and Dmean（63.62±1.28 vs 64.07±1.08，P=0.021）. VMAT also gave significantly lower PTV-V₁₀₅ coverage（t=-8.216，P<0.001）. The two methods were associated with similar conformity index （t=-0.147，P=0.884），homogeneity index （t=2.56，P=0.89），spinal dose （P=0.743） and heart dose（P=0.519）. VMAT was associated with lower lung V₂₀ than IMRT（t=-12.690，P<0.001），as well as lower lung V₃₀（t=-2.870，P=0.007） and lower mean lung dose（t=-3.659，P=0.001）. Mean MU was 24% lower with VMAT than with IMRT （572.33 vs 754.95）. Conclusion In patients with esophageal neoplasms，VMAT can provide equivalent or superior dose distributions compared to IMRT，and it can generate more and better GTV hotspots. VMAT is also associated with lower lung V₂₀ and V₃₀，lower MU， and higher delivery efficiency. These findings suggest that VMAT has strong potential for treating esophageal cancer.

Key words:  Esophageal neoplasm, Radiotherapy, Static intensity modulate radiotherapy, Volumetric modulated arc therapy, Dosimetry