Feasibility and potential advantages using VMAT in SRS metastasis treatments

Abstract

background: Utilization of stereotactic radiosurgery (srs) for brain metastases (BM) has become the technique of choice as opposed to whole brain radiation therapy (WBrT). The aim of this work is to evaluate the feasibility and potential benefits in terms of normal tissue (NT) and dose escalation of volumetric modulated arc therapy (VMaT) in srs metastasis treatment. a VMaT optimization procedure has therefore been developed for internal dose scaling which minimizes planner dependence. Materials and methods:Five patient-plans incorporating treatment with frame-based srs with dynamic conformal arc technique (Da) were re-planned for VMaT. The lesions selected were between 4-6 cm 3 . The same geometry used in the Da plans was maintained for the VMaT cases. a VMaT planning procedure was performed attempting to scale the dose in inner auxiliary volumes, and to explore the potential for dose scaling with this technique. comparison of dose-volume histogram (DVh) parameters were obtained. results: VMaT allows a superior NT sparing plus conformity and dose scaling using the auxiliary volumes. The VMaT results were significantly superior in NT sparing, improving both the V 10 and V 12 values in all cases, with a 2-3 cm 3 saving. In addition, VMaT improves the dose coverage D 95 by about 0.5 Gy. The objective of dose escalation was achieved with VMaT with an increment of the Dmean and the Dmedian of about 2 Gy. conclusions: This work shows a benefit of VMaT in srs treatment with significant NT sparing. a VMaT optimization procedure, based on auxiliary inner volumes, has been developed, enabling internal dose escalation.

Frameless LINAC Stereotactic Radiosurgery for Brain Metastasis using VMAT: A Review of 20 Cases and Institutional Experience

“…These findings align with previous studies highlighting the precision and effectiveness of SRS in treating brain lesions [5,6]. The use of VMAT in SRS has shown promise in terms of treatment planning and verification, as demonstrated by Perez-Calatayud, et al, [12]. VMAT allows a superior normal tissue sparing plus conformity and dose scaling using the auxiliary volumes [12,15].…”

“…The use of VMAT in SRS has shown promise in terms of treatment planning and verification, as demonstrated by Perez-Calatayud, et al, [12]. VMAT allows a superior normal tissue sparing plus conformity and dose scaling using the auxiliary volumes [12,15].…”

“…Feasibility and potential benefit of VMAT in SRS treatment of the 4-6 cm 3 size metastasis for normal tissue sparing and internal dose escalation has been demonstrated with VMAT optimization procedure, based on auxiliary inner volumes, for dose scaling [12]. This manuscript reviews the feasibility and institutional experience of frameless LINAC-based SRS using VMAT for the treatment of brain metastases.…”

Frameless LINAC Stereotactic Radiosurgery for Brain Metastasis using VMAT: A Review of 20 Cases and Institutional Experience

“…These findings align with previous studies highlighting the precision and effectiveness of SRS in treating brain lesions [5,6]. The use of VMAT in SRS has shown promise in terms of treatment planning and verification, as demonstrated by Perez-Calatayud, et al, [12]. VMAT allows a superior normal tissue sparing plus conformity and dose scaling using the auxiliary volumes [12,15].…”

“…Feasibility and potential benefit of VMAT in SRS treatment of the 4-6 cm 3 size metastasis for normal tissue sparing and internal dose escalation has been demonstrated with VMAT optimization procedure, based on auxiliary inner volumes, for dose scaling [12]. This manuscript reviews the feasibility and institutional experience of frameless LINAC-based SRS using VMAT for the treatment of brain metastases.…”