Palliation of Vertebral Metastases with Radiotherapy: Exploration of Volumetric-Modulated Arc Therapy From Development to Implementation in Routine Clinical Practice

Can Conformity-Based Volumetric Modulated Arc Therapy Improve Dosimetry and Speed of Delivery in Radiation Therapy to Lumbosacral Spine Compared with Conventional Techniques?

“…This study found that ''conformity-based'' VMAT provided more conformal and homogeneous dose distributions for LS spine pRT than the two most common field-based planning techniques. These findings are consistent with those from other evaluations of VMAT for palliative spine radiotherapy [9][10][11]16], but without the need to delineate OARs to guide the optimization process. Conformality is a good indicator of dose beyond the field and can be used as a surrogate for normal tissue sparing.…”

“…In this study, VMAT and POP had comparable delivery times, which were approximately half the delivery time of the junctioned plan. Rozanec et al [11] found a larger delivery time reduction with VMAT compared with the junctioned technique (10 minutes to 3 minutes), which may be because of differences in the number of segments used, the beam arrangement, or variations in delivery systems. In combination, these findings suggest that concerns about VMAT delivery times are unfounded and should not hinder the application of VMAT for pRT.…”

“…In addition, volumetric modulated arc therapy (VMAT) has improved target conformality and coverage, decreased the dose to organs at risk (OARs), and reduced treatment times in several disease sites [5][6][7][8]. Specifically for palliative spine radiotherapy, VMAT resulted in significant improvements in target conformality and homogeneity and bowel and kidney dose and a 50% reduction in treatment time [9][10][11].…”

A Canadian experience of palliative advanced practice radiation therapy TIPS: Training, implementation, practice and sustainability

“…As recognized leaders on the pRT team and beyond, pCSRTs can influence jurisdictions to achieve necessary changes and improvements in practice/processes, as demonstrated by pCSRTs' research and knowledge translation, academic contribution, and stakeholder experiences [6,12,14,18,21,[27][28][29][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Table 3 summarizes the metrics used by pCSRTs to illustrate their influence, along with the methodology used to gather information.…”

Comparison of Rapid to Standard Volumetric Modulated Arc Therapy for Palliative Radiotherapy in Lung Cancer Patients

“…As the use of volumetric modulated arc therapy (VMAT) becomes more widespread, interest in utilizing this advanced technique for treatments with palliative intent in an effort to decrease toxicity has grown [ 5 - 7 ]. While VMAT is associated with several dosimetric advantages that may translate into improved outcomes for patients, the technique involves complex planning and quality assurance that can strain department resources and result in slower turn-around times for patient treatments, which may often be unacceptable for symptomatic palliative patients.…”