Potential advantages of volumetric arc therapy in head and neck cancer

Barrachina, J. Gómez-Millán; Sainz, I. Jerez; Pérez-Rozos, A.; Ros, J. Carlos Ramirez; Serrano, Mariana; Pérez, Yolanda Lupiáñez; Carmona, J.A. Medina

doi:10.1002/hed.23685

Cited by 20 publications

(16 citation statements)

References 33 publications

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“…Despite VMAT having been introduced in clinical practice approximately 10 years ago and despite its wide application in many different clinical indications [ 2 – 10 ], its application to the treatment of breast cancer is still limited. This is reflected in the paucity of published reports on clinical experiences.…”

Section: Discussionmentioning

confidence: 99%

“…A number of earlier published reviews [ 2 – 10 ] addressed some early technical aspects of VMAT or covered the role of VMAT in general or in other districts (lung, head and neck, brain or SBRT). Fiorentino [ 6 ] proposed a case review of a bilateral breast irradiation with a limited review of literature, mostly focused on tomotherapy practice.…”

Section: Introductionmentioning

confidence: 99%

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Critical appraisal of the role of volumetric modulated arc therapy in the radiation therapy management of breast cancer

et al. 2017

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Background: The aim of this review is the critical appraisal of the current use of volumetric modulated arc therapy for the radiation therapy management of breast cancer. Both clinical and treatment planning studies were investigated. Material and methods: A Pubmed/MEDLINE search of the National Library of Medicine was performed to identify VMAT and breast related articles. After a first order rejection of the irrelevant findings, the remaining articles were grouped according to two main categories: clinical vs. planning studies and to some sub-categories (pointing to significant technical features). Main areas of application, dosimetric and clinical findings as well as areas of innovations were defined.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Critical appraisal of the role of volumetric modulated arc therapy in the radiation therapy management of breast cancer

et al. 2017

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“…Volumetric modulated arc therapy (VMAT), a new technique based on conventional IMRT, is reported to outperform conventional IMRT by modulating gantry rotation speed, dose rate, and shapes of multileaf collimator (MLC) [ 8 , 9 ]. Several studies in NPC and other HNCs have demonstrated that VMAT can achieve a shorter delivery time, lower MUs, superior or equivalent dose coverage, and better OAR protection compared with conventional IMRT treatment [ 10 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma

Zhou

Shen

et al. 2018

BioMed Research International

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Purpose To compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) in treating early T-stage nasopharyngeal carcinoma (NPC). Method Ten patients with early T-stage NPC who received tomotherapy using simultaneously integrated boost (SIB) strategies were replanned with VMAT (RapidArc of Varian, dual-arc). Dosimetric comparisons between the RapidArc plan and the HT plan included the following: (1) D98, homogeneity, and conformity of PTVs; (2) sparing of organs at risk (OARs); (3) delivery time and monitor units (MUs). Results (1) Compared with RapidArc, HT achieved better dose conformity (CI of PGTVnx + nd: 0.861 versus 0.818, P = 0.004). (2) In terms of OAR protection, RapidArc exhibited significant superiority in sparing ipsilateral optic nerve (Dmax: 27.5Gy versus 49.1Gy, P < 0.001; D2: 23.5Gy versus 48.2Gy, P < 0.001), contralateral optic nerve (Dmax: 30.4Gy versus 49.2Gy, P < 0.001; D2: 26.2Gy versus 48.1Gy, P < 0.001), and optic chiasm (Dmax: 32.8Gy versus 48.3Gy, P < 0.001; D2: 30Gy versus 47.6Gy, P < 0.001). HT demonstrated a superior ability to protect the brain stem (D1cc: 43.0Gy versus 45.2Gy, P = 0.012), ipsilateral temporal lobe (Dmax 64.5Gy versus 66.4 Gy, P = 0.015), contralateral temporal lobe (Dmax: 62.8Gy versus 65.1Gy, P = 0.001), ipsilateral lens (Dmax: 4.27Gy versus 5.24Gy, P = 0.009; D2: 4.00Gy versus 5.05Gy, P = 0.002; Dmean: 2.99Gy versus 4.31Gy, P < 0.001), contralateral lens (Dmax: 4.25Gy versus 5.09Gy, P = 0.047; D2: 3.91Gy versus 4.92Gy, P = 0.005; Dmean: 2.91Gy versus 4.18Gy, P < 0.001), ipsilateral parotid (Dmean: 36.4Gy versus 41.1Gy, P = 0.002; V30Gy: 54.8% versus 70.4%, P = 0.009), and contralateral parotid (Dmean: 33.4Gy versus 39.1Gy, P < 0.001; V30Gy: 48.2% versus 67.3%, P = 0.005). There were no statistically significant differences in spinal cord or pituitary protection between the RapidArc plan and the HT plan. (3) RapidArc achieved a much shorter delivery time (3.8 min versus 7.5 min, P < 0.001) and a lower MU (618MUs versus 5646MUs, P < 0.001). Conclusion Our results show that RapidArc and HT are comparable in D98, dose homogeneity, and protection of the spinal cord and pituitary gland. RapidArc performs better in shortening delivery time, lowering MUs, and sparing the optic nerve and optic chiasm. HT is superior in dose conformity and protection of the brain stem, temporal lobe, lens, and parotid.

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“…Volumetric modulated arc therapy (VMAT) is a novel radiation technique that creates conformal distributions with variable gantry speed, dynamic movements of multileaf collimators and variations in dose-rate and that seems to have multiple advantages for head and neck tumours namely: increase of therapeutic index associated to a decrease of second tumours, decrease delivery time with lower range of intra-fraction motion, fewer set-up errors and better compliance to treatment [17]. We found out that patients treated with VMAT had worse DFS and CSS rates comparing to patients treated with 3D-conformal RT, although without statistical significance (p = 0.244, p = 0.116).…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinomas of the sinonasal tract: a case series from an Oncology Centre in Northern Portugal

Veloso-Teles

Ribeiro

Silva

et al. 2014

Eur Arch Otorhinolaryngol

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Sinonasal malignant neoplasms are rare and adenocarcinomas account for 10-20 % of these cancers. Our aim is to characterise the clinical presentation, risk factors and outcomes of patients with adenocarcinoma treated at our institution. Retrospective review of medical records of patients with sinonasal adenocarcinomas, treated at IPO-Porto from January 2008 until December 2012. Twenty-eight patients with adenocarcinomas were selected from a total of 53 patients with sinonasal cancers. There was a male predominance (93 %), a mean age at diagnosis of 56 years and a rate of occupational wood dust exposure of 71 %. The most common treatment option was surgery followed by adjuvant radiotherapy. The 5 year disease-free and cancer-specific survival was 58 and 60 %, respectively. The following factors had negative impact on disease-free survival: advanced AJCC stage (p = 0.014); skull base invasion (p = 0.002); poorly differentiated or mucinous subtypes histology (p = 0.034) and imaging findings of residual tumour before adjuvant radiotherapy (p < 0.001). Endoscopic tumour resection was not associated with adverse outcomes. The role of volume-modulated arch therapy in the treatment of sinonasal tumours has to be clarified. The higher rate of adenocarcinomas among sinonasal cancers in this series comparing with previous reports, even from our institution, suggests that this pathology is rising in Northern Portugal. Despite substantial local failure, sinonasal adenocarcinomas have a relatively favourable prognosis in terms of cancer-specific survival.

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Potential advantages of volumetric arc therapy in head and neck cancer

Cited by 20 publications

References 33 publications

Critical appraisal of the role of volumetric modulated arc therapy in the radiation therapy management of breast cancer

Critical appraisal of the role of volumetric modulated arc therapy in the radiation therapy management of breast cancer

Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma

Adenocarcinomas of the sinonasal tract: a case series from an Oncology Centre in Northern Portugal

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