The feasibility and efficacy of new SBRT technique HyperArc for recurrent nasopharyngeal carcinoma: noncoplanar cone-based robotic system vs. noncoplanar high-definition MLC based Linac system

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

“…In this study, two groups of FSRT treatment plans are the homogeneous and inhomogeneous delivery groups. Traditionally, the characteristics of the MLC-based Linac treatment plan is a more homogeneous dose distribution 15 , 16 . The homogeneous delivery group (keeping the maximal dose of the treatment plan less than 110%) was generated for each patient to meet the same corresponding CK treatment plan criteria by using HA with SRS normal tissue objective (SRS NTO) optimization algorithm (HA-S) and coplanar RA techniques.…”

FLASH instead of proton arc therapy is a more promising advancement for the next generation proton radiotherapy

“…Frankly speaking, we knew the importance of the degree of freedom from the beginning of the journey in radiotherapy when Dr. Leksell invented Gamma Knife, where hundreds of cobalt 60 sources focused the gamma‐ray on the tiny targets 33 . Nowadays, VMAT utilizing the arc trajectories is dominating the routine practice via C‐arm typed LINACs, 35,44 and 4pi approaches are dominating in the cranial region where a superior dose fall‐off is preferred, even though the radiobiology is still not fully understood in the hypofractionation regimens 5,45,46 …”

“…33 Nowadays, VMAT utilizing the arc trajectories is dominating the routine practice via C-arm typed LINACs, 35,44 and 4pi approaches are dominating in the cranial region where a superior dose fall-off is preferred, even though the radiobiology is still not fully understood in the hypofractionation regimens. 5,45,46 Unfortunately, the importance of an increased degree of freedom has been somewhat overlooked in particle beam therapy's routine clinical practice, where the fantasy about utilizing a couple of beam angles to spare the healthy tissue via the Bragg peak has been dominating the community in the last half -century, [47][48][49][50] One of the major concerns of utilizing more beam angles is the spilling of the low dose to the healthy tissue, which has not been seen or studied before, and the excessive low dose volume may defeat the purpose of using particle beam therapy. 38,51,52 Another major concern is that the current technology might not be able to support the massive dynamic rotational gantry while delivering the spot within a submillimeter accuracy.…”