Dosimetric advantage of volumetric modulated arc therapy in the treatment of intraocular cancer

Deng, Zhenmiao; Shen, Lanxiao; Zheng, Xiaomin; Zhou, Yanfang; Jin, Yi; Han, Ce; Xie, Conghua; Jin, Xiance

doi:10.1186/s13014-017-0819-7

Cited by 15 publications

(16 citation statements)

References 29 publications

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“…Photon TMI was originally conceived with arc therapy using the TomoTherapy system and later the RapidArc system from Varian. Several works have demonstrated the benefits of VMAT versus conventional photon treatment planning for a variety of different sites ( 27 – 29 ). Typically, VMAT offers superior dose coverage and reduction of OAR dose as compared to step-and-shoot intensity-modulated radiation therapy (IMRT) at the cost of increased planning time.…”

Section: Discussionmentioning

confidence: 99%

Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy

et al. 2022

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PurposeThe goal of this study is to investigate treatment planning of total marrow irradiation (TMI) using intensity-modulated spot-scanning proton therapy (IMPT). The dosimetric parameters of the intensity-modulated proton plans were evaluated and compared with the corresponding TMI plans generated with volumetric modulated arc therapy (VMAT) using photon beams.MethodsIntensity-modulated proton plans for TMI were created using the Monte Carlo dose-calculation algorithm in the Raystation 11A treatment planning system with spot-scanning proton beams from the MEVION S250i Hyperscan system. Treatment plans were generated with four isocenters placed along the longitudinal direction, each with a set of five beams for a total of 20 beams. VMAT-TMI plans were generated with the Eclipse-V15 analytical anisotropic algorithm (AAA) using a Varian Trilogy machine. Three planning target volumes (PTVs) for the bones, ribs, and spleen were covered by 12 Gy. The dose conformity index, D80, D50, and D10, for PTVs and organs at risk (OARs) for the IMPT plans were quantified and compared with the corresponding VMAT plans.ResultsThe mean dose for most of the OARs was reduced substantially (5% and more) in the IMPT plans for TMI in comparison with VMAT plans except for the esophagus and thyroid, which experienced an increase in dose. This dose reduction is due to the fast dose falloff of the distal Bragg peak in the proton plans. The conformity index was found to be similar (0.78 vs 0.75) for the photon and proton plans. IMPT plans provided superior superficial dose coverage for the skull and ribs in comparison with VMAT because of increased entrance dose deposition by the proton beams.ConclusionTreatment plans for TMI generated with IMPT were superior to VMAT plans mainly due to a large reduction in the OAR dose. Although the current IMPT-TMI technique is not clinically practical due to the long overall treatment time, this study presents an enticing alternative to conventional TMI with photons by providing superior dose coverage of the targets, increased sparing of the OARs, and enhanced radiobiological effects associated with proton therapy.

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Section: Discussionmentioning

confidence: 99%

Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy

et al. 2022

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“…Quantitative evaluation of plans was performed by means of standard DVH, MUs, HI and CI. 13 Doses to OARs and coverage of the PTV were evaluated using a DVH. Given the superior location of tumor, interest for critical structure sparing only included dose to esophagus, dose to heart, mean dose to the total lung, volume of the total lung receiving 20 Gy, maximum dose to the spinal cord.…”

Section: Methodsmentioning

confidence: 99%

Comprehensive Comparison of Progressive Optimization Algorithm Based Automatic Plan and Manually Planned Treatment Technique for Cervical-Thoracic Esophageal Cancers

Zhou

Xiang

Xiong

et al. 2020

Technol Cancer Res Treat

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Purpose: The purpose of the present study was first to apply the progressive optimization algorithm based automatic volumetric modulated arc therapy (POA-VMAT) technology to accelerate and improve the radiotherapy of cervicothoracic esophageal cancer (CTEC). We comprehensive analyze the feasibility, normal tissue complication probability (NTCP) and dosimetric results of POA-VMAT, manual based VMAT and step-shoot intensity-modulated radiation therapy (IMRT) plans in the treatment of CTEC. Methods: Sixty patients with CTEC with or without concomitant chemotherapy at our institution between 2017 and 2019 were retrospectively identified. The manual 7field-IMRT (7f-IMRT), Single-arc-VMAT and Double-arc-VMAT (Single-Arc/Double-Arc) plans were generated in all cases. The POA-VMAT was designed using the automatic dual-arc VMAT technology of Pinnacle3 9.10 planning system based on progressive optimization algorithm. Specially, it includes the selection of treatment techniques, the running of automated planning scripts, and the evaluation of the final radiotherapy regimen. Subsequently, quantitative evaluation of plans was performed by means of standard dose–volume histograms, homogeneity index (HI) and conformity index (CI). Results: Target dose conformity of the 7f-IMRT plan was inferior to all plans, whereas the Double-Arc plan was slightly inferior to the POA-VMAT but superior to the Single-Arc and 7f-IMRT plan. The HI for 7f-IMRT, Single-Arc, Double-Arc and POA-VMAT were 0.17 ± 0.08, 0.28 ± 0.06, 0.29 ± 0.06 and 0.28 ± 0.03, respectively. For the NTCP results, there was significant statistical difference among POA-VMAT, IMRT and VMAT plans. The total MU was reduced by 48.3% and 42.1% in Single-Arc and POA-VMAT plans compare to IMRT plans. Conclusions: By comprehensive consideration, POA-VMAT efficiently generate acceptable treatment plans for CTEC without dose escalation to OARs and overall superior to manual planning which is a good option for treating CTEC.

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“…After 2015, the number of publications is increased significantly. There are 9 publications in 2016 [118][119][120][121][122][123][124][125][126], 7 publications in 2017 [127][128][129][130][131][132][133], 10 publications in 2018 [134][135][136][137][138][139][140][141][142][143], 9 publications in 2019 [144][145][146][147][148][149][150][151][152] and 8 publications in 2020 [153][154][155][156][157][158][159][160]. Within the subspecialty of radiation therapy, the numbers of publications in the fields of clinical implementation, plan optimization, plan evaluation and quality assurance are 23 papers (37%), 16 papers (26%), 14 papers (23%) and 9 papers (14%), respectively.…”

Section: Scientific Researchmentioning

confidence: 99%

The status of medical physics in radiotherapy in China

Yan

Huang

et al. 2021

Physica Medica

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To present an overview of the status of medical physics in radiotherapy in China, including facilities and devices, occupation, education, research, etc. Materials and methods: The information about medical physics in clinics was obtained from the 9-th nationwide survey conducted by the China Society for Radiation Oncology in 2019. The data of medical physics in education and research was collected from the publications of the official and professional organizations. Results: By 2019, there were 1463 hospitals or institutes registered to practice radiotherapy and the number of accelerators per million population was 1.5. There were 4172 medical physicists working in clinics of radiation oncology. The ratio between the numbers of radiation oncologists and medical physicists is 3.51. Approximately, 95% of medical physicists have an undergraduate or graduate degrees in nuclear physics and biomedical engineering. 86% of medical physicists have certificates issued by the Chinese Society of Medical Physics. There has been a fast growth of publications by authors from mainland of China in the top international medical physics and radiotherapy journals since 2018. Conclusions: Demand for medical physicists in radiotherapy increased quickly in the past decade. The distribution of radiotherapy facilities in China became more balanced. High quality continuing education and training programs for medical physicists are deficient in most areas. The role of medical physicists in the clinic has not been clearly defined and their contributions have not been fully recognized by the community.Prof. Xu Haichao in 1940s at Peking Union Medical College (PUMC). He worked with Prof. Marvin Williomus, an American medical physicist, to treat cancer patients using a 400 kV X-ray unit [7]. The department of radiology in Caner Institute of Chinese Academy of Medical Sciences (CICAMS) started to treat patients with a Cobalt-60 unit in 1958. At the same year, the division of radiation physics in CICAMS was founded. They made the manual multi-leaf collimator and installed it on Cobalt-60 machine in 1965. Later, they made the remote control system for brachytherapy machine using Cobalt-60 source ball in 1965Cobalt-60 source ball in -1967.From 1970, China began to build linear accelerators and on-board imaging devices. As a result, 25 MeV Betatron, Simulator and Cobalt-60 brachytherapy machine were produced by Tianjing therapeutic instrument factory [9]. Meanwhile, Beijing Medical Apparatus and Instruments Institute built the first linear accelerator [10]. Since 1976, the major hospitals started to purchase high-end linear accelerators, CT, Brachytron and planning software from USA and Europe [11]. Following the clinical application of the linear accelerators, text books in Chinese

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Dosimetric advantage of volumetric modulated arc therapy in the treatment of intraocular cancer

Cited by 15 publications

References 29 publications

Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy

Treatment planning of total marrow irradiation with intensity-modulated spot-scanning proton therapy

Comprehensive Comparison of Progressive Optimization Algorithm Based Automatic Plan and Manually Planned Treatment Technique for Cervical-Thoracic Esophageal Cancers

The status of medical physics in radiotherapy in China

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