mARC prostate treatment planning with Varian Eclipse for flat vs. FFF beams

Bell, Katharina; Dzierma, Yvonne; Palm, Jan; Nuesken, Frank; Licht, Norbert; Rübe, Christian

doi:10.1016/j.ejmp.2016.02.011

Cited by 16 publications

(20 citation statements)

References 11 publications

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“…Removing the flattening filter eliminates the main source of photon scatter in the treatment head and thus explains lower measured values for FFF as it has also been reported by Dobler et al 16. with a similar experimental setup, Bell et al 13. and Dzierma et al 11.…”

Section: Discussionmentioning

confidence: 92%

“…Bell et al. report a standard of 11 beams 13. However, they did not find clinically relevant differences compared to their mArc rotation technique (which is described different from VMAT), which also resulted in shorter delivery times and therefore was recommended.…”

Section: Discussionmentioning

confidence: 93%

“…This is again in accordance with the results of Dobler et al 16. at another localization and Bell et al 13. with another rotation technique (mArc).…”

Section: Discussionmentioning

confidence: 99%

“…Although there are some other publications regarding the treatment of patients with prostate carcinoma using linacs with FFF mode, they refer to other types of rotational technique and manufacturers and different treatment planning systems (TPS) 11, 12, 13. However, the design of the linac head affects the PD14 and the penumbra of the beam.…”

Section: Introductionmentioning

confidence: 99%

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Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Treutwein¹,

Hipp

Koelbl³

et al. 2017

J Applied Clin Med Phys

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This study on patients with localized prostate cancer was set up to investigate valuable differences using flattened beam (FB) and flattening filter free (FFF) mode in the application of intensity‐modulated radiotherapy (IMRT) and volumetric‐modulated arc therapy (VMAT). For ten patients, four different plans were calculated with Oncentra planning system of Elekta, using Synergy machines: IMRT and VMAT, with and without flattening filter. Homogeneity and conformity indexes, dose to the organs at risk, and measurements of peripheral dose and dosimetric plan verification including record of the delivery times were analyzed and statistically evaluated. The indexes for homogeneity and conformity (CTV and PTV) are either advantageous or not significantly different for FFF compared to FB with one minor exception. Regarding the doses to the organs at risk and the measured peripheral dose, equivalent or lower doses were delivered for FFF than with FB. Furthermore, the delivery times were significantly shorter for FFF. VMAT compared to IMRT reveals benefits or at least equivalent values. VMAT‐FFF combines the most advantageous plan quality parameters with the shortest delivery times and reduced peripheral dose and is therefore recommended for the given equipment and cancer localization.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 93%

“…This is again in accordance with the results of Dobler et al 16. at another localization and Bell et al 13. with another rotation technique (mArc).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Treutwein¹,

Hipp

Koelbl³

et al. 2017

J Applied Clin Med Phys

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“…Clinical practice of modern RT is largely depended on daily application of information systems, [25,26] such as health information system (HIS) and radiotherapy treatment planning systems ]RTPS; e.g., Varian Eclipse TM (CA, USA), [27] Oncentra (Nucletron, CA, USA), [28] and Elekta Monaco (Sunnyvale, CA, USA) [29] ]. However, the 2 types of information systems are varied and mutually exclusive in data sharing.…”

Section: Discussionmentioning

confidence: 99%

Enhancing clinical effectiveness of pre-radiotherapy workflow by using multidisciplinary-cooperating e-control and e-alerts

Lin¹,

Hung

Lee

et al. 2017

Medicine

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Radiotherapy (RT) is useful in managing cancer diseases. In clinical practice, early initiation of RT is crucial for enhancing tumor control. But, delivering precise RT requires a series of pre-RT working processes in a tight staff-cooperation manner. In this regard, using information system to conduct e-control and e-alerts has been suggested to improve practice effectiveness; however, this effect is not well defined in a real-world RT setting.We designed an information system to perform e-control and e-alerts for the whole process of pre-RT workflow to shorten processing time, to improve overall staff satisfaction, and to enhance working confidence.A quality-improving study conducted in a large RT center.Externally validated data were retrospectively analyzed for comparison before (from Sep. 2012 to Dec. 2012, n = 223) and after (from Sep. 2013 to Dec. 2013, n = 240) implementation of pre-RT e-control and e-alerts.Applying the e-control with delay-working e-alerts in pre-RT workflow was the main intervention.Nine workstations were identified in pre-RT workflow. The primary outcome measure was the processing time in each pre-RT workstations before and after implementing the e-control and e-alerts. Secondary measures were staff-working confidence and near-missing cases during the process of pre-RT workflow.After implementing e-control, overall processing time of pre-RT workflow was shortened from 12.2 days to 8.9 days (P < .001). Follow-up data (till Jul. 2016) showed a durable effect of 9.2 days, being still below the predefined threshold of <10 days.Using a multidisciplinary-cooperating information system is useful to conduct e-control and e-alerts in the whole process of pre-RT workflow. Clinical effectiveness, staff satisfaction, and working confidence are able to be enhanced obviously.

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Secondary malignancy risk for patients with localized prostate cancer after intensity‐modulated radiotherapy with and without flattening filter

Treutwein¹,

Loeschel

Hipp

et al. 2020

J Applied Clin Med Phys

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Men treated for localized prostate cancer by radiotherapy have often a remaining life span of 10 yr or more. Therefore, the risk for secondary malignancies should be taken into account. Plans for ten patients were evaluated which had been performed on an Oncentra ® treatment planning system for a treatment with an Elekta Synergy™ linac with Agility™ head. The investigated techniques involved IMRT and VMTA with and without flattening filter. Different dose response models were applied for secondary carcinoma and sarcoma risk in the treated region and also in the periphery. As organs at risk we regarded for carcinoma risk urinary bladder, rectum, colon, esophagus, thyroid, and for sarcoma risk bone and soft tissue. The excess absolute risk (EAR) was found very similar in the treated region for both techniques (IMRT and VMAT) and also for both with and without flattening filter. The secondary sarcoma risk resulted about one magnitude smaller than the secondary carcinoma risk. The EAR to the peripheral organs was statistically significant reduced by application of the flattening filter free mode concerning the flattening filter as main source of scattered dose. Application of flattening filter free mode can thus support to reduce second malignancy risk for patients with localized prostate cancer.

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mARC prostate treatment planning with Varian Eclipse for flat vs. FFF beams

Cited by 16 publications

References 11 publications

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Volumetric‐modulated arc therapy and intensity‐modulated radiation therapy treatment planning for prostate cancer with flattened beam and flattening filter free linear accelerators

Enhancing clinical effectiveness of pre-radiotherapy workflow by using multidisciplinary-cooperating e-control and e-alerts

Secondary malignancy risk for patients with localized prostate cancer after intensity‐modulated radiotherapy with and without flattening filter

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