Simultaneous integrated boost radiotherapy for bilateral breast: a treatment planning and dosimetric comparison for volumetric modulated arc and fixed field intensity modulated therapy

Nicolini, G.; Clivio, Alessandro; Fogliata, Antonella; Vanetti, Eugenio; Cozzi, Luca

doi:10.1186/1748-717x-4-27

Cited by 109 publications

(116 citation statements)

References 34 publications

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“…The delivery time was equal to

4.6 \pm 0.7

min per dual arc and was considerably less than the 7F‐IMRT delivery time. Studies on other VMAT approaches based on double RapidArc approaches ( 8 , 51 , 52 ) have shown delivery times ranging from 2.6 to 3.9 min that are faster than our results, whilst other improved IMAT approaches ( 53 , 54 ) have displayed delivery times ranging from 6.3 to 14 min for conventional linac‐based techniques. Here, we did not determine the fastest method, as previous reports were not performed under the same measurement conditions.…”

Section: Discussioncontrasting

confidence: 66%

Comparative analysis of SmartArc‐based dual arc volumetric‐modulated arc radiotherapy (VMAT) versus intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma

Lee

Chao

Ting

et al. 2011

J Applied Clin Med Phys

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The purpose of this study was to evaluate and quantify the planning performance of SmartArc‐based volumetric‐modulated arc radiotherapy (VMAT) versus fixed‐beam intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) using a sequential mode treatment plan. The plan quality and performance of dual arc‐VMAT (DA‐VMAT) using the Pinnacle3 Smart‐Arc system (clinical version 9.0; Philips, Fitchburg, WI, USA) were evaluated and compared with those of seven‐field (7F)‐IMRT in 18 consecutive NPC patients. Analysis parameters included the conformity index (CI) and homogeneity index (HI) for the planning target volume (PTV), maximum and mean dose, normal tissue complication probability (NTCP) for the specified organs at risk (OARs), and comprehensive quality index (CQI) for an overall evaluation in the 11 OARs. Treatment delivery time, monitor units per fraction (MU/fr), and gamma (Γ3mm,3%) evaluations were also analyzed. DA‐VMAT achieved similar target coverage and slightly better homogeneity than conventional 7F‐IMRT with a similar CI and HI. NTCP values were only significantly lower in the left parotid gland (for xerostomia) for DA‐VMAT plans. The mean value of CQI at 0.98±0.02 indicated a 2% benefit in sparing OARs by DA‐VMAT. The MU/fr used and average delivery times appeared to show improved efficiencies in DA‐VMAT. Each technique demonstrated high accuracy in dose delivery in terms of a high‐quality assurance (QA) passing rate (>98%) of the (Γ3mm,3%) criterion. The major difference between DA‐VMAT and 7F‐IMRT using a sequential mode for treating NPC cases appears to be improved efficiency, resulting in a faster delivery time and the use of fewer MU/fr.PACS number: 87.53.Tf, 87.55.x, 87.55.D, 87.55.dk

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“…The delivery time was equal to

4.6 \pm 0.7

Section: Discussioncontrasting

confidence: 66%

Comparative analysis of SmartArc‐based dual arc volumetric‐modulated arc radiotherapy (VMAT) versus intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma

Lee

Chao

Ting

et al. 2011

J Applied Clin Med Phys

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“…On the toxicity side, besides the attention given to spinal cord and brain stem (with toxicity thresholds of 45-50 Gy for the first and at 50 Gy for the second in most of the investigations), it is consolidated knowledge that, for parotids, mean doses inferior to [25][26][27][28][29][30] Gy correlate well with substantial recovery of function within two years (Li et al (4), Deasy et al (5)). Higher thresholds were observed for sub-mandibular glands in the range of 39 Gy by Murdoc et al (6), while a dose to oral cavity of about 30Gy for late mucositis was reported by Narayan et al (7).…”

Section: Introductionmentioning

confidence: 99%

Early clinical experience with volumetric modulated arc therapy in head and neck cancer patients

et al. 2010

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“…These techniques have been shown to improve dose conformity to the target and minimize the high dose to critical organs 17 , 18 . However, common drawbacks of these advanced techniques include the extended time needed, higher monitor units of the beam delivery, (19) and an increased low‐dose bath area 13 , 14 , 17 , 20 . Volumetric‐modulated arc therapy (VMAT), (21) an improvement of the IMRT technique, was developed in 2008, and was named as RapidArc by Varian Medical Systems.…”

Section: Introductionmentioning

confidence: 99%

“…Compared to fixed‐beam IMRT and helical tomotherapy, the beam delivery time of the VMAT technique was reduced to approximately 1.5 to 3 minutes for a 2 Gy irradiation, and the monitor units of the beam were also decreased (21) . Thus, some recent publications 19 , 22 have investigated the potential of using the VMAT technique on whole breast irradiation.…”

Section: Introductionmentioning

confidence: 99%

The feasibility study of using multiple partial volumetric‐modulated arcs therapy in early stage left‐sided breast cancer patients

Tsai

Lin

Lee

et al. 2012

J Applied Clin Med Phys

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The purpose of this study was to assess the feasibility of using a multiple partial volumetric‐modulated arcs therapy (MP‐VMAT) technique on the left breast irradiation and to evaluate the dosimetry and treatment efficiency. Ten patients with left‐sided breast cancer who had been treated by whole breast irradiation were selected for the treatment plan evaluation by using six partial volumetric modulated arcs. Each arc consisted of a 50° gantry rotation. The planning target volumes and the normal organs, including the right breast, the bilateral lungs, left ventricle, heart, and unspecified tissue, were contoured on the CT images. Dose‐volume histograms were generated and the delivery time for each arc was recorded. The PTV received greater than 95% of the V95 for all cases, and the maximum dose was within ±1% of 110% of the prescription dose. The mean homogeneity index (HI) was 10.61±0.99, and mean conformity index (CI) was 1.21±0.03. The mean dose, V5, V10, V25, and V30 of the heart were 7.61±1.38 Gy, 59.73% ±15.87%, 24.39% ±6.82%, 2.52% ±1.11%, and 1.57% ±0.71%, respectively. The volume of the left ventricle receiving 25 Gy was 5.15% ±2.23%. The total lung mean dose was 5.57±0.36 Gy, with V5 of 25.39% ±3.88% and V20 of 5.66% ±0.89%. The right breast received a mean dose of 2.13±0.22 Gy, with V5 of 1.83% ±1.22% and V10 of 0.04% ±0.12%. The mean dose of unspecified tissue was 5.34±0.37 Gy and V5 was 22.23% ±1.57%. The volume of the unspecified tissue receiving 50 Gy was 0.50% ±0.14%. The mean delivery time for each arc was 13.9 seconds. The average MU among ten patients was 511 MU (range 443 to 594 MUs). The MP‐VMAT technique for the left‐sided breast cancer patients achieved adequate target dose coverage while maintaining low doses to organs‐at‐risk, and therefore reduced the potential for induction of second malignancy and side effects. The highly efficient treatment delivery would be beneficial for improving patient throughput, providing patient comfort, and achieving precise treatment with the breathing control system.PACS number: 87.55.‐x, 87.55.D‐, 87.55.dk

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Simultaneous integrated boost radiotherapy for bilateral breast: a treatment planning and dosimetric comparison for volumetric modulated arc and fixed field intensity modulated therapy

Abstract: RapidArc showed dosimetric improvements with respect to IMRT, delivery parameters confirmed its logistical advantages, pre-treatment dosimetry proved its reliability.

Cited by 109 publications

References 34 publications

Comparative analysis of SmartArc‐based dual arc volumetric‐modulated arc radiotherapy (VMAT) versus intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma

Comparative analysis of SmartArc‐based dual arc volumetric‐modulated arc radiotherapy (VMAT) versus intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma

Early clinical experience with volumetric modulated arc therapy in head and neck cancer patients

The feasibility study of using multiple partial volumetric‐modulated arcs therapy in early stage left‐sided breast cancer patients

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