A study of minimum segment width parameter on VMAT plan quality, delivery accuracy, and efficiency for cervical cancer using Monaco TPS

Wang, Yuanyuan; Chen, li; Zhu, Fengying; Guo, Wei; Zhang, Dandan; Sun, Wenzhao

doi:10.1002/acm2.12422

Cited by 24 publications

(31 citation statements)

References 16 publications

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“…Planning relevant parameters (arc length, number of arcs, gantry angle interval, etc.) in the treatment planning system (TPS) affects the optimization of the plan and therefore influences its quality (Abbas et al, 2013;Masi, Doro, Favuzza, Cipressi, & Livi, 2013;Treutwein, Hipp, Koelbl, & Dobler, 2012;Wang et al, 2018). The Eclipse and Pinnacle TPS uses the gantry spacing (GS) parameter in VMAT planning; the length of the VMAT arc is equally divided by GS and each GS corresponds to one control point (CP).…”

Section: Introductionmentioning

confidence: 99%

The influence of increment of gantry on VMAT plan quality for cervical cancer

Chen

et al. 2019

Journal of Radiation Research and Applied Sciences

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This study aimed to assess the influence of increment of gantry (IG) value on plan quality among cervical cancer patients treated with volumetric modulated arc therapy (VMAT). Twenty postoperative cervical cancer patients receiving radiotherapy were selected. Four different VMAT plans were designed in Monaco TPS using the same optimization conditions but with varying IG parameters (10°, 20°, 30°, and 40°). The IG10 group did not meet the clinical requirements. The target dose of the IG20 group was slightly worse than that of IG30 and IG40 groups; the differences in dose distribution in organs at risk among the IG20, IG30, and IG40 groups were negligible. The average monitoring units of the IG20, IG30, and IG40 groups were 704.6, 594.6, and 572.6, and the average control points of the three groups were 134.4, 139.4, and 140.3, respectively. The plan delivery times of the three groups were 117.6 s, 111.0 s, and 118.1 s, respectively. At a 3% dose difference and a 3 mm distance to agreement, the gamma pass rates of the IG20, IG30, and IG40 plans were 99.1%, 99.6%, and 99.4%, respectively. Considering the plan quality, the dose accuracy, and delivery efficiency, IG30 is recommended for cervical cancer VMAT planning.

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Section: Introductionmentioning

confidence: 99%

The influence of increment of gantry on VMAT plan quality for cervical cancer

Chen

et al. 2019

Journal of Radiation Research and Applied Sciences

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“…Two coplanar full arcs rotating in clockwise and anticlockwise directions were used. The segment width was set to 1.0 cm 15 and the increment of gantry was 30° 16 . All VMAT plans were designed to satisfy the dose constraints introduced by the RTOG 0418 for modulated radiotherapy 17 .…”

Section: Methodsmentioning

confidence: 99%

Risk for second bladder and rectal malignancies from cervical cancer irradiation

Mazonakis

Lyraraki

Tolia

et al. 2021

J Applied Clin Med Phys

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The objective of this study was to estimate the risk of developing second malignancies to partially in-field organs from volumetric modulated arc therapy (VMAT) of cervical cancer and to compare the above risks with those from the conventional three-dimensional conformal radiotherapy (3D-CRT). Seventeen consecutive patients with uterine cervix carcinoma were selected. VMAT and 3D-CRT plans were generated with 6 and 10 MV photons, respectively. The prescribed tumor dose was 45 Gy given in 25 fractions. Differential dose-volume histogram data from the treatment plans were obtained for the partially in-field organs such as bladder and rectum. These data were used to estimate the patient-specific lifetime attributable risk (LAR) for bladder and rectal cancer induction with a non-linear model based on a mixture of plateau and bell-shaped dose-response relationships. The estimated risks per 10000 people were compared with the baseline risks for unexposed population.The patient-specific rectal cancer risk estimates from VMAT were significantly lower than those from 3D-CRT (P = 0.0144). The LARs for developing bladder malignancies from VMAT were significantly high compared to those from conventional irradiation (P = 0.0003). The mean difference between the patient-specific LARs for radiation-induced bladder and rectal malignancies as derived from 3D-CRT and VMAT plans was 6.6% and 2.0%, respectively. The average LAR for developing bladder and rectal malignant diseases due to VMAT was 9.2 × 10 -4 and 43.7 × 10 -4 , respectively. The corresponding risks following 3D-CRT were 8.6 × 10 -4 and 44.6 × 10 -4 . These average risks showed that pelvic irradiation increases the baseline probability for cancer induction by 12.6-19.1%. The differences in the second cancer risks associated with the VMAT and 3D-CRT for cervical cancer were found to be small. Both treatment techniques resulted in considerable increased probabilities for developing bladder and rectal malignancies relative to those of unirradiated population.

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“…An NPC IMRT plan usually includes hundreds of segments. The setting of the optimization parameters, such as gantry angle increment and minimum segment width, during planning affects the dose distribution and the delivery efficiency of the radiotherapy plan, thereby affecting plan quality (Chen et al, 2019;Wang et al, 2018). The number of control points in the IMRT plan determines the number of segments; an increase in the number of control points results in an increase in the number of segments and the degrees of freedom for plan modulation, thus improving plan quality.…”

Section: Introductionmentioning

confidence: 99%

Effect of the number of control points on the plan quality of intensity-modulated radiotherapy for nasopharyngeal carcinoma

Chen

et al. 2021

Journal of Radiation Research and Applied Sciences

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This study aimed to investigate the effect of the number of control points (CPs) on the plan quality, plan delivery efficiency, and gamma passing rate (GPR) of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Twenty patients with NPC were selected. With all other optimization conditions unchanged, only the number of CPs in each field was changed and optimized to formulate four groups of IMRT plans (CP10, CP15, CP20, and CP25) for each case. An IMRT factor (IF) was used to evaluate the plan complexity, and the plan quality index (PQI) was employed to measure the plan quality. The MatriXX was used to measure each plan, and the plan delivery time (PDT) was recorded. The CP20 group had the lowest PQI (20.2%), while the CP10 group had the highest PQI (51.4%). The monitor unit (MU) values and PDTs gradually increased as the number of control points increased, while the MUs/segment significantly decreased. A negative correlation was observed between GPR and IF at the three commonly used criteria (R 2 = 0.39, 0.39, and 0.41, respectively). Considering the IMRT plan quality and the efficiency and accuracy of plan delivery, 20 CPs per field should be used in the IMRT planning for NPC.

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A study of minimum segment width parameter on VMAT plan quality, delivery accuracy, and efficiency for cervical cancer using Monaco TPS

Cited by 24 publications

References 16 publications

The influence of increment of gantry on VMAT plan quality for cervical cancer

The influence of increment of gantry on VMAT plan quality for cervical cancer

Risk for second bladder and rectal malignancies from cervical cancer irradiation

Effect of the number of control points on the plan quality of intensity-modulated radiotherapy for nasopharyngeal carcinoma

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