Stereotactic ablative radiation therapy with volumetric modulated arc therapy in flattening filter-free mode for low-, intermediate-, and high-risk prostate cancer patients: Are 2 arcs better than 1?

Fortin, D.; Mestrovic, Ante; Alexander, Abraham

doi:10.1016/j.prro.2015.04.002

Cited by 6 publications

(10 citation statements)

References 20 publications

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“…Several studies have shown that using a single VMAT arc in PO plans is favoured over two arcs, being dosimetrically equivalent and requiring shorter treatment times [7, 8]. Shorter delivery times minimize the risk of intra-fraction motion which is highly relevant, especially in the SABR settings.…”

Section: Discussionmentioning

confidence: 99%

“…The different optimal arc of PA300 proposed in the present study could be due to the different planning system/Linacs used (Elekta vs Varian). In an investigation of the use of FFF single arc vs. dual arcs VMAT techniques for low-, intermediate- and high-risk prostate cancer, Fortin et al also favoured the use of a single arc (FA) in all risk groups planned (10 F, 36.25Gy in 5 fractions) [8]. However, their definition of CTV for high-risk patients was the prostate + lower 2 cm SV and did not include PLN, once more making their plans equivalent to our presented PO plans.…”

Section: Discussionmentioning

confidence: 99%

“…Several arc arrangements were investigated. Single VMAT arcs were used for PO plans [7, 8] while, after initial investigations for PPLN plans, dosimetrically acceptable plans were only achieved using two VMAT arcs.…”

Section: Methodsmentioning

confidence: 99%

“…Due to the potentially low alpha-beta ratio for the prostate (high sensitivity to fraction size), hypo-fractionation is thought to improve the therapeutic ratio for prostate radiation therapy (RT), i.e., improving tumour control rates while maintaining similar normal tissue biological effective dose compared to conventional fractionation regimens [5, 6]. Prostate SABR using volumetric modulated arc therapy (VMAT) provides highly conformal plans, with excellent tumour coverage and organs at risk (OARs) sparing [7, 8]. One major advantage for VMAT over conventional techniques is the shorter treatment times.…”

Section: Introductionmentioning

confidence: 99%

“…SABR-VMAT with flattening-filter free (FFF) photon beams has been reported to be safe and effective [4, 9]. The high dose rates possible with FFF beams and the reduced leakage and scatter dose to the patient are the main reasons behind the increased use in SABR-VMAT for prostate [8–10] and prostate and pelvic lymph nodes [11]. …”

Section: Introductionmentioning

confidence: 99%

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Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation

et al. 2016

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BackgroundThe purpose of this study is to find the optimal planning settings for prostate SABR-VMAT for high-risk prostate cancer patients irradiated to prostate only (PO) or prostate and pelvic lymph nodes (PPLN).MethodsFor 10 patients, plans using 6MV flattened, flattening-filter-free (FFF) 6MV (6 F) and FFF 10MV (10 F) photon beams with full and partial arc arrangements were generated and compared. The prescribed dose was 40Gy to the prostate with 25Gy to the PLN in 5 fractions. Plans were then evaluated for PTV coverage, dose fall-off, and OAR doses. The number of monitor units and the treatment delivery times were also compared. Statistical differences were evaluated using a paired sample Wilcoxon signed rank test with a significance level of 0.05%.ResultsA total of 150 plans were generated for this study. Acceptable PO plans were obtained using single arcs, while two arcs were necessary for PPLN. All plans were highly conformal (CI ≥1.3 and CN ≥0.90) with no significant differences in the PTV dose coverage. 6MV plans required significantly longer treatment time and had higher dose spillage compared to FFF plans. Superior plans were obtained using 10 F 300° partial arcs for PO with the lowest rectal dose, dose spillage and the shortest treatment times. For PPLN, 6 F and 10 F plans were equivalent.ConclusionsSABR-VMAT with FFF photon beams offers a clear benefit with respect to shorter treatment delivery times and reduced dose spillage. Class solutions using a single 10 F 300° arc for PO and two 10 F or 6 F partial 300° arcs for PPLN are proposed.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-016-0730-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation

et al. 2016

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AAPM WGVRTO report 390: A survey of veterinary radiation oncology equipment and infrastructure in 2022

Basran,

Turek,

Selting

et al. 2024

Medical Physics

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Since 2010, there has been little published data on the state of equipment and infrastructure in veterinary radiation oncology clinical practice. These data are important not only to identify the status and use of technology within the veterinary radiation oncology community but also to help identify the extent of medical physics support. The purpose of our study is to report findings from a survey of veterinary radiation oncologists in the USA, Canada, and select centers outside of North America in 2022. A 40‐question survey covering topics such as type of radiotherapy equipment, techniques offered, treatment planning systems and dose calculation algorithms, special techniques, board‐certified radiation oncologists and residents, and extent of medical physics support was distributed through an online survey tool. Results from 40 veterinary radiation oncology institutions, with equipment explicitly used for veterinary care, suggest that the current state of practice is not dissimilar to what currently exists in human radiation oncology facilities; techniques and technologies commonly employed include flattening filter‐free mode megavoltage beams, volumetric arc therapy, daily cone‐beam computed tomography, image‐guided radiation therapy, and sophisticated dose calculation algorithms. These findings suggest the need for modern radiation oncology acceptance testing, commissioning, and quality assurance programs within the veterinary community. The increase in veterinary radiation oncology residency positions and increasing sophistication of equipment suggests that increased levels of standardized medical physics support would benefit the veterinary radiation oncology community.

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SBRT targets that move with respiration

2018

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Stereotactic ablative radiation therapy with volumetric modulated arc therapy in flattening filter-free mode for low-, intermediate-, and high-risk prostate cancer patients: Are 2 arcs better than 1?

Cited by 6 publications

References 20 publications

Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation

Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation

AAPM WGVRTO report 390: A survey of veterinary radiation oncology equipment and infrastructure in 2022

SBRT targets that move with respiration

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