Dosimetric Impact of Breathing Motion in Lung Stereotactic Body Radiotherapy Treatment Using Image-Modulated Radiotherapy and Volumetric Modulated Arc Therapy

Rao, M; Wu, Joanne; Cao, D.; Wong, Tony; Mehta, Vivek; Shepard, David; Ye, Jinsong

doi:10.1016/j.ijrobp.2011.12.001

Cited by 119 publications

(129 citation statements)

References 18 publications

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“…This effect has been studied in only two publications for tangential fields techniques39, 40 but not for VMAT for breast. However, the interplay effect has been largely studied in the case of lung RT41, 42, 43, 44, 45, 46 with motion amplitude being largely superior to those encountered in breast treatment. Those studies show that the interplay effect generates a blurring effect on the dose distribution.…”

Section: Discussionmentioning

confidence: 99%

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Tyran

Tallet

Resbeut

et al. 2018

J Applied Clin Med Phys

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PurposeThis study evaluates the benefit of a virtual bolus method for volumetric modulated arc therapy (VMAT) plan optimization to compensate breast modifications that may occur during breast treatment.MethodsTen files were replanned with VMAT giving 50 Gy to the breast and 47 Gy to the nodes within 25 fractions. The planning process used a virtual bolus for the first optimization, then the monitors units were reoptimized without bolus, after fixing the segments shapes. Structures and treatment planning were exported on a second scanner (CT) performed during treatment as a consequence to modifications in patient's anatomy. The comparative end‐point was clinical target volume's coverage. The first analysis compared the VMAT plans made using the virtual bolus method (VB‐VMAT) to the plans without using it (NoVB‐VMAT) on the first simulation CT. Then, the same analysis was performed on the second CT. Finally, the level of degradation of target volume coverage between the two CT using VB‐VMAT was compared to results using a standard technique of forward‐planned multisegment technique (Tan‐IMRT).ResultsUsing a virtual bolus for VMAT does not degrade dosimetric results on the first CT. No significant result in favor of the NoVB‐VMAT plans was noted. The VB‐VMAT method led to significant better dose distribution on a second CT with modified anatomies compared to NoVB‐VMAT. The clinical target volume's coverage by 95% (V95%) of the prescribed dose was 98.9% [96.1–99.6] on the second CT for VB‐VMAT compared to 92.6% [85.2–97.7] for NoVB‐VMAT (P = 0.0002). The degradation of the target volume coverage for VB‐VMAT is not worse than for Tan‐IMRT: the median differential of V95% between the two CT was 0.9% for VMAT and 0.7% for Tan‐IMRT (P = 1).ConclusionThis study confirms the safety and benefit of using a virtual bolus during the VMAT planning process to compensate potential breast shape modifications.

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Section: Discussionmentioning

confidence: 99%

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Tyran

Tallet

Resbeut

et al. 2018

J Applied Clin Med Phys

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“…Besides, organ motion has become an important consideration for SBRT treatment planning for tumors in the thorax, abdomen and prostate that are known to move with breathing motion. 10 The management of motion control is established with the setup of motion encompassing methods such as respiratory gated imaging, breath hold technique, forced shallow breathing with abdominal compression, etc. Also, a stringent tolerance limit is required in MLC leaf position to deliver the dose in small and highly complex apertures created by the VMAT optimization.…”

Section: Introductionmentioning

confidence: 99%

Influence of segment width on plan quality for volumetric modulated arc based stereotactic body radiotherapy

Nithiyanantham¹,

Mani²,

Subramani³

et al. 2014

Reports of Practical Oncology & Radiotherapy

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“…The use of daily localization with CBCT could detect changes in the target and ensure the safety of OARs 34. As the spatial distribution of biological properties in tumors such as proliferation and hypoxia are known to be nonuniform, the dose distribution that maximizes tumor control probability for a given tumor is also nonuniform.…”

Section: Discussionmentioning

confidence: 99%

Reducing dose to the lungs through loosing target dose homogeneity requirement for radiotherapy of non small cell lung cancer

Miao

Yan

Tian

et al. 2017

J Applied Clin Med Phys

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It is important to minimize lung dose during intensity‐modulated radiation therapy (IMRT) of nonsmall cell lung cancer (NSCLC). In this study, an approach was proposed to reduce lung dose by relaxing the constraint of target dose homogeneity during treatment planning of IMRT. Ten NSCLC patients with lung tumor on the right side were selected. The total dose for planning target volume (PTV) was 60 Gy (2 Gy/fraction). For each patient, two IMRT plans with six beams were created in Pinnacle treatment planning system. The dose homogeneity of target was controlled by constraints on the maximum and uniform doses of target volume. One IMRT plan was made with homogeneous target dose (the resulting target dose was within 95%–107% of the prescribed dose), while another IMRT plan was made with inhomogeneous target dose (the resulting target dose was more than 95% of the prescribed dose). During plan optimization, the dose of cord and heart in two types of IMRT plans were kept nearly the same. The doses of lungs, PTV and organs at risk (OARs) between two types of IMRT plans were compared and analyzed quantitatively. For all patients, the lung dose was decreased in the IMRT plans with inhomogeneous target dose. On average, the mean dose, V5, V20, and V30 of lung were reduced by 1.4 Gy, 4.8%, 3.7%, and 1.7%, respectively, and the dose to normal tissue was also reduced. These reductions in DVH values were all statistically significant (P < 0.05). There were no significant differences between the two IMRT plans on V25, V30, V40, V50 and mean dose for heart. The maximum doses of cords in two type IMRT plans were nearly the same. IMRT plans with inhomogeneous target dose could protect lungs better and may be considered as a choice for treating NSCLC.

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Dosimetric Impact of Breathing Motion in Lung Stereotactic Body Radiotherapy Treatment Using Image-Modulated Radiotherapy and Volumetric Modulated Arc Therapy

Cited by 119 publications

References 18 publications

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Safety and benefit of using a virtual bolus during treatment planning for breast cancer treated with arc therapy

Influence of segment width on plan quality for volumetric modulated arc based stereotactic body radiotherapy

Reducing dose to the lungs through loosing target dose homogeneity requirement for radiotherapy of non small cell lung cancer

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