A radiotherapy planning study of RapidArc, intensity modulated radiotherapy, three‐dimensional conformal radiotherapy, and parallel opposed beams in the treatment of pediatric retroperitoneal tumors

Shaffer, Richard; Vollans, E.; Vellani, R.; Welsh, Margaret; Moiseenko, Vitali; Goddard, Karen

doi:10.1002/pbc.22649

Cited by 19 publications

(22 citation statements)

References 22 publications

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“…Table 4 presents a synopsis of delivery parameters from recent reports that addressed the role of VMAT for the treatment of abdominal tumors, compared with the findings of the current study. It is clear that the MU/Gy in our IMRT plans was much less than that reported in other studies, although the target volumes, planning objectives and dose per fraction were different in these studies [7, 14, 15]. In addition, the MU/Gy in our VMAT plans was within the wide range that has been previously reported [7, 14, 15].…”

Section: Discussionsupporting

confidence: 46%

“…It is clear that the MU/Gy in our IMRT plans was much less than that reported in other studies, although the target volumes, planning objectives and dose per fraction were different in these studies [7, 14, 15]. In addition, the MU/Gy in our VMAT plans was within the wide range that has been previously reported [7, 14, 15]. Therefore the difference in the MU increase is mainly related to the number of MU in the IMRT plans, and not to the number of MU in the VMAT plans.…”

Section: Discussionmentioning

confidence: 58%

“…Nevertheless, only a modest reduction (21.3%) in delivery time was observed in our study. As can be seen in Table 4, the average treatment time in the current study is longer than that reported when delivering VMAT using RapidArc on Varian accelerators [7, 14, 15]. This difference is mainly due to the binned dose rate mode on current Elekta accelerators.…”

Section: Discussionmentioning

confidence: 59%

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Four-dimensional CT-based evaluation of volumetric modulated arc therapy for abdominal lymph node metastasis from hepatocellular carcinoma

Zhang

Deng

et al. 2012

Journal of Radiation Research

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This study aimed to identify the potential benefits and limitations of a new volumetric modulated arc therapy (VMAT) planning system in Monaco, compared with conventional intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Four-dimensional CT scans of 13 patients with abdominal lymph node metastasis from hepatocellular carcinoma were selected. Internal target volume was defined as the combined volume of clinical target volumes (CTVs) in the multiple 4DCT phases. Dose prescription was set to 45 Gy for the planning target volume (PTV) in daily 3.0-Gy fractions. The PTV dose coverage, organs at risk (OAR) doses, delivery parameters and treatment accuracy were assessed. Compared with 3DCRT, both VMAT and IMRT provided a systematic improvement in PTV coverage and homogeneity. Planning objectives were not fulfilled for the right kidney, in which the 3DCRT plans exceeded the dose constraints in two patients. Equivalent target coverage and sparing of OARs were achieved with VMAT compared with IMRT. The number of MU/fraction was 462 ± 68 (3DCRT), 564 ± 105 (IMRT) and 601 ± 134 (VMAT), respectively. Effective treatment times were as follows: 1.8 ± 0.2 min (3DCRT), 6.1 ± 1.5 min (IMRT) and 4.8 ± 1.0 min (VMAT). This study suggests that the VMAT plans generated in Monaco improved delivery efficiency for equivalent dosimetric quality to IMRT, and were superior to 3DCRT in target coverage and sparing of most OARs. However, the superiority of VMAT over IMRT in delivery efficiency is limited.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 59%

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Four-dimensional CT-based evaluation of volumetric modulated arc therapy for abdominal lymph node metastasis from hepatocellular carcinoma

Zhang

Deng

et al. 2012

Journal of Radiation Research

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“…A planning study by Shaffer et al [157] evaluated single arc VMAT in 8 paediatric cases with retroperitoneal tumours in comparison with 7-field fixed field IMRT (SW), 3D-CRT and a parallel-opposed pair (POP) plan. VMAT and IMRT were able to achieve improved conformity and lower dose to the liver compared with 3D-CRT and POP, but at the expense of greater MU usage.…”

Section: Paediatric Casesmentioning

confidence: 99%

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Teoh

Clark²,

Wood³

et al. 2011

BJR

578

440

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ABSTRACT. Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites.

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“…There is a dosedependent risk of late effects on normal tissues such as the liver and kidneys, which may lie adjacent to the target volume and incidentally be included in the high-dose irradiated volume. There have been many developments in the planning and delivery of radiotherapy in recent years, including the use of intensity modulated radiotherapy, which has the potential to improve the conformity of dose distributions, potentially enabling dose escalation to tumors and reduction of toxicity to organs at risk [92,93]. The use of these techniques within pediatric oncology has been controversial, owing to the potential increase in secondary malignancies because of the increased low dose to nontarget tissues [94,95].…”

Section: Radiotherapymentioning

confidence: 98%

Ten Challenges in the Management of Neuroblastoma

et al. 2012

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Neuroblastoma is a complex disease with many contradictions and challenges. It is, by and large, a cancer of babies and preschool children, but it does occur, albeit increasingly rarely, in older children, adolescents and young adults. The prognosis is very variable, with outcome related to age, stage and molecular pathology. Neuroblastoma may behave in an almost benign way, with spontaneous regression in some infants, but the majority of older patients have high-risk disease, which is usually fatal, despite best current treatments. As a rare disease, international collaboration is essential to run clinical trials of adequate statistical power to answer important questions in a reasonable time frame. High-risk disease requires multimodality therapy including chemotherapy, surgery and radiotherapy as well as biological and immunological treatments for optimal outcomes. Innovative treatment approaches, sometimes associated with appreciable toxicity, offer hope for the future but, despite parental wishes, cannot be generally implemented without adequate assessment in clinical trials.

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A radiotherapy planning study of RapidArc, intensity modulated radiotherapy, three‐dimensional conformal radiotherapy, and parallel opposed beams in the treatment of pediatric retroperitoneal tumors

Cited by 19 publications

References 22 publications

Four-dimensional CT-based evaluation of volumetric modulated arc therapy for abdominal lymph node metastasis from hepatocellular carcinoma

Four-dimensional CT-based evaluation of volumetric modulated arc therapy for abdominal lymph node metastasis from hepatocellular carcinoma

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Ten Challenges in the Management of Neuroblastoma

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