Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer

Davidson, Melanie; Blake, S; Batchelar, Deidre; Cheung, Patrick; Mah, Kandice

doi:10.1016/j.ijrobp.2010.10.024

Cited by 99 publications

(80 citation statements)

References 21 publications

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“…DVH analysis and the Wilcoxon test for the femurs V 40Gy showed that the IMRT technique is safer for femurs than the 3D-CRT. Some authors recommend dose constraint for the femur to be V 50Gy < 5% [17]. However, in this study, these structures were not exposed to such high doses and therefore V 40Gy was selected for analysis instead.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Poncyljusz

Kukołowicz

Chorąży

et al. 2017

Nowotwory. Journal of Oncology

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Background. Irradiation of a larger volume of the target may lead to an increase of the doses delivered to the surrounding organs at risk (OAR) for post-prostatectomy patients with a higher risk of nodal involvement. It was anticipated that IMRT significantly improved OAR sparing. The aim of this study was to provide a dosimetric comparison between conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) treatment plans for patients with prostate cancer irradiated to the prostate bed and pelvic lymph-nodal area. Materials and methods. The 3D-CRT and IMRT plans were created for ten patients after prostatectomy. The treatment plans were generated for the prostate bed (PTV1) and the pelvic lymph nodes (PTV2). The sum of PTV1 and PTV2 was irradiated to a mean dose of 46 Gy in 23 fractions, and additionally PTV1 was irradiated to a mean dose of 18 Gy in 9 fractions. Target coverage and the doses delivered to the pelvic bones, the rectum, the bladder, the bowel bag, and the femurs, were compared between techniques. The Wilcoxon signed-rank test was used to compare the dosimetric parameters. Results. The dosimetric quality of 3D-CRT and IMRT plans were comparable for target coverage (the mean value of PTV1 V95%, the mean value of PTV2 V95% all > 99%). The IMRT plans resulted in significant reductions in the pelvic bones Conclusions. The analysis presented in this paper demonstrates that the IMRT technique reduces the delivered dose to the OARs. Most interesting was the possibility of reducing the delivered dose to the pelvic bones and the bowel bag. This allowed us to expect a decreased risk of acute hematologic toxicity and acute gastrointestinal toxicity. NOWOTWORY J Oncol 2016; 66, 6: 440-444

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Section: Discussionmentioning

confidence: 99%

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Poncyljusz

Kukołowicz

Chorąży

et al. 2017

Nowotwory. Journal of Oncology

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“…The dosimetric outcome differed when comparing plans using RapidArc and the VMAT in comparison to IMRT in the treatment of prostate cancer [13][14][15][16][17][18][19][20][21][22][23][24] . Many studies observed better normal tissue sparing with VMAT over IMRT when including simple target volume (prostate with or without seminal vesicles) though shortened treatment time did not differ between both modalities 12,14,16,17,[19][20][21]23 .…”

Section: Introductionmentioning

confidence: 99%

Dosimetric Evaluation of Advanced Radiotherapy Techniques in Treating Patients with Prostatic Cancer

Amin

Sayed

Ezzat

2017

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Different radiotherapy techniques were developed to deliver optimal dose to prostate cancer while sparing nearby organs at risk (OARs). Aim: To compare different dosimetric methods used to evaluate sparing of OARs and to select radiotherapy plan which provides the most OARs sparing during prostate cancer treatment. Methods: We used computed tomography data sets of 10 patients. For each data set, six plans were calculated; two RapidArc, two intensity-modulated radiation therapy (IMRT), and two 3-dimensional conformal radiotherapy (3DCRT) plans. Isodose distribution and dose volume histograms (DVHs) were used for plan analysis and evaluation. The dose to OAR was compared by calculating the DVH for each OAR in different plans. The dose (D) delivered to certain percentage (n) of an organ (Dn) was then determined. In addition, the Critical Organ Scoring Index (COSI) and the modified COSI (mCOSI) were calculated. Results: 3DCRT with 5 fields produced the lowest rectal dose, RapidArc with bladder avoidance sector (RapidArcBladder) produced the lowest bladder dose and IMRT with 9 beams produced the lowest dose to the femoral heads. The COSI and MCOSI values of the two IMRT plans were significantly lower than those of 3DCRT and RapidArc (<0.0001). The calculation of mCOSI produced similar results to that obtained with COSI (<0.0001). Conclusion:The results of this study showed that COSI and MCOSI are better dosimetric methods in selecting the plan with more sparing of OARs than Dn. Meanwhile among advanced radiotherapy techniques, RapidArc and 3DCRT are more sparing of OARs than IMRT.

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“…Compared to intensity‐modulated radiation therapy (IMRT), where the gantry is static during dose delivery, VMAT offers more precise target coverage with lower monitor units (MU) 3, 4. Furthermore, the delivery times for VMAT treatments are shorter compared to IMRT treatments,5 potentially reducing the intra‐fractional patient movement during deliveries 6.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the delivery times for VMAT treatments are shorter compared to IMRT treatments,5 potentially reducing the intra‐fractional patient movement during deliveries 6. VMAT deliveries require a complex treatment plan, involving three key dynamic components; (a) gantry rotation, (b) dose rate modulation, and (c) multi‐leaf collimator (MLC) motion, which are all simultaneously varied during the delivery 2, 3, 4, 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

A novel and independent method for time‐resolved gantry angle quality assurance for VMAT

Fuangrod

Greer

Zwan

et al. 2017

J Applied Clin Med Phys

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Volumetric‐modulated arc therapy (VMAT) treatment delivery requires three key dynamic components; gantry rotation, dose rate modulation, and multi‐leaf collimator motion, which are all simultaneously varied during the delivery. Misalignment of the gantry angle can potentially affect clinical outcome due to the steep dose gradients and complex MLC shapes involved. It is essential to develop independent gantry angle quality assurance (QA) appropriate to VMAT that can be performed simultaneously with other key VMAT QA testing. In this work, a simple and inexpensive fully independent gantry angle measurement methodology was developed that allows quantitation of the gantry angle accuracy as a function of time. This method is based on the analysis of video footage of a “Double dot” pattern attached to the front cover of the linear accelerator that consists of red and green circles printed on A4 paper sheet. A standard mobile phone is placed on the couch to record the video footage during gantry rotation. The video file is subsequently analyzed and used to determine the gantry angle from each video frame using the relative position of the two dots. There were two types of validation tests performed including the static mode with manual gantry angle rotation and dynamic mode with three complex test plans. The accuracy was 0.26° ± 0.04° and 0.46° ± 0.31° (mean ± 1 SD) for the static and dynamic modes, respectively. This method is user friendly, cost effective, easy to setup, has high temporal resolution, and can be combined with existing time‐resolved method for QA of MLC and dose rate to form a comprehensive set of procedures for time‐resolved QA of VMAT delivery system.

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Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer

Cited by 99 publications

References 21 publications

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Comparison of 3D-CRT and IMRT techniques in radiotherapy for post-prostatectomy patients with a higher risk of nodal involvement

Dosimetric Evaluation of Advanced Radiotherapy Techniques in Treating Patients with Prostatic Cancer

A novel and independent method for time‐resolved gantry angle quality assurance for VMAT

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