Volumetric intensity-modulated arc therapy vs. 3-dimensional conformal radiotherapy for primary chemoradiotherapy of anal carcinoma

Weber, Hanne Elisabeth; Dröge, Leif Hendrik; Hennies, Steffen; Herrmann, Markus K. A.; Gaedcke, Jochen; Wolff, Hendrik A.

doi:10.1007/s00066-015-0859-6

Cited by 15 publications

(18 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, in the exclusive setting of anal cancer, 4 chemoradiation studies (1 Phase I and 3 retrospective ones accounting for 103 patients) were analyzed. 78 – 81 One of them 80 investigated the irradiation of a single volume with either 2 full arcs or 4 half-arc VMAT technique and 6 MV photon energies. The delivered dose of 50.4 Gy at 1.8 per fraction caused mostly severe skin toxicity (29.4%), with low GI (11.8%) and GU (5.9%) severe toxicity.…”

Section: Resultsmentioning

confidence: 99%

“…In 3 studies, 78 – 80 elective lymph nodes received doses between 45 and 49.5 Gy (1.5 Gy/fraction); clinically detectable lymph nodes were treated with doses from 50.4 to 54 Gy (1.8–2 Gy/fraction), and macroscopic anal disease received doses from 50.4 to 59.4 Gy (1.8 Gy/fraction). Noteworthy, the SIB approach was able to shorten the overall treatment time with a consequent potential benefit on treatment outcomes.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Volumetric modulated arc therapy for treatment of solid tumors: current insights

Macchia¹,

Deodato²,

Cilla³

et al. 2017

OTT

View full text Add to dashboard Cite

AimThis article discusses the current use of volumetric modulated arc therapy (VMAT) techniques in clinical practice and reviews the available data from clinical outcome studies in different clinical settings. An overview of available literature about clinical outcomes with VMAT stereotactic/radiosurgical treatment is also reported.Materials and methodsAll published manuscripts reporting the use of VMAT in a clinical setting from 2009 to November 2016 were identified. The search was carried out in December 2016 using the National Library of Medicine (PubMed/Medline). The following words were searched: “volumetric arc therapy”[All Fields] OR “vmat”[All Fields] OR “rapidarc”[All Fields], AND “radiotherapy”[All Fields] AND “Clinical Trial”[All Fields].ResultsOverall, 37 studies (21 prospective and 16 retrospective) fulfilling inclusion criteria and thus included in the review evaluated 2,029 patients treated with VMAT; of these patients, ~30.8% had genitourinary (GU) tumors (81% prostate, 19% endometrial), 26.2% head-and-neck cancer (H&NC), 13.9% oligometastases, 11.2% had anorectal cancer, 10.6% thoracic neoplasms (81% breast, 19% lung), and 7.0% brain metastases (BMs). Six different clinical scenarios for VMAT use were identified: 1) BMs, 2) H&NC, 3) thoracic neoplasms, 4) GU cancer, 5) anorectal tumor, and 6) stereotactic body radiation therapy (SBRT) performed by VMAT technique in the oligometastatic patient setting.ConclusionThe literature addressing the clinical appropriateness of VMAT is scarce. Current literature suggests that VMAT, especially when used as simultaneous integrated boost or SBRT strategy, is an effective safe modality for all cancer types.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Volumetric modulated arc therapy for treatment of solid tumors: current insights

Macchia¹,

Deodato²,

Cilla³

et al. 2017

OTT

View full text Add to dashboard Cite

show abstract

“…We included eight studies that compared chemoradiation with intensity-modulated radiotherapy (IMRT) to chemoradiation with 3D radiotherapy in stage I-III anal cancer patients. These included one single-centre RCT [58] (N = 20, risk of bias: 'some concerns'), three register-based cohort studies from the US [59][60][61] (moderate to serious risk of bias), and four single-centre retrospective cohort studies [62][63][64][65][66] (moderate to serious risk of bias). A significant advantage for IMRT was seen with respect to OS [HR 0.86 (0.76-0.98), GRADE: ⨁◯◯◯, 5,246 pts.…”

Section: Number Of Hits and Included Studiesmentioning

confidence: 99%

“…from 1 RCT [58]], DFS [HR 0.31 (0.09-1.05, GRADE: ⨁◯◯◯, 103 pts. from 1 observational study [64]], and CFS [HR 0.75 (0.07-8.18, GRADE: ⨁◯◯◯, 89 pts. from 1 observational study [62]].…”

Section: Number Of Hits and Included Studiesmentioning

confidence: 99%

State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

Werner

Gaskins

Valle

et al. 2021

Radiotherapy and Oncology

View full text Add to dashboard Cite

“…Several studies have shown that VMAT performs equally in PTV coverage, with equal or possibly improved OAR sparing compared with that obtained using 3D CRT and IMRT 2 , 6 , 7 , 8 , 9 . In addition, VMAT delivers treatment with less beam‐on time and less monitor units (MUs) than IMRT.…”

Section: Introductionmentioning

confidence: 99%

A novel arc geometry setting for pelvic radiotherapy with extensive nodal involvement

Rossi

Boman

Skyttä

et al. 2016

J Applied Clin Med Phys

View full text Add to dashboard Cite

The aim of this study was to find optimal planning approach for large planning targets with complicated geometry requiring wide field openings. The study presents a novel approach for arc geometry design for pelvic targets with extensive nodal involvement. A total of 15 patients with anorectal carcinoma or vulvar cancer were selected retrospectively. For each patient, one seven‐field IMRT plan and three VMAT plans were calculated: one with two 360° arcs with no limitations for the field size (VMATw); one with two asymmetrically field‐size‐restricted 360° arcs (VMATr); and the proposed novel approach which consisted of one 360° arc with the field size restricted to the central PTV, and another arc divided into two 180° arcs, restricting the field sizes with the focus on the lymph nodes. The techniques were compared in terms of PTV coverage false(normalVPTVfalse(95%false)false), dose maximum (D(max)), dose conformity index (CI), homogeneity index (HI), and organs at risk doses. The proposed novel approach with one full and two half arcs tended to have better PTV coverage (normalVPTVfalse(95%false)=97%±2%, compared to 95%±3%,95%±3%, and 97%±2% in VMATw, VMATr, and 7f‐IMRT, respectively) and lower maxima (Dfalse(maxfalse)=107%±1%, compared to 110%±3%,110%±4%, and 110%±4% in VMATw, VMATr, and 7f‐IMRT, respectively); and lower or equal organs at risk doses. The superiority of the proposed technique false(CI=1.16±0.05,HI=9±2false) was more pronounced compared with the VMATw plans (CI=1.41±0.10, paired t‐test p<0.001;HI=12±2,p<0.001), but the proposed technique was slightly better also in comparison with the VMATr plans false(CI=1.21±0.07,p<0.001;HI=11±4,p=0.015false) and 7f‐IMRT plans false(CI=1.18±0.03,p=0.016;HI=10±2,p=0.215false). Radiotherapy treatment planning for large and complicated treatment volumes benefits not only from restricting the field size but also from careful field design that considers PTV geometry. This optimizes multileaf collimator movements, leading to better dose conformity and homogeneity.PACS number(s): 87.53.Jw, 87.55.D, 87.56.jk:

show abstract

Volumetric intensity-modulated arc therapy vs. 3-dimensional conformal radiotherapy for primary chemoradiotherapy of anal carcinoma

Abstract: VMAT was shown to be a feasible technique, achieving significantly lower rates of acute organ toxicity and promising results for LRC and DFS. Future investigations will aim at assessing the advantages of VMAT with respect to late toxicity and survival after a prolonged follow-up time.

Cited by 15 publications

References 40 publications

Volumetric modulated arc therapy for treatment of solid tumors: current insights

Volumetric modulated arc therapy for treatment of solid tumors: current insights

State of the art treatment for stage I to III anal squamous cell carcinoma: A systematic review and meta-analysis

A novel arc geometry setting for pelvic radiotherapy with extensive nodal involvement

Contact Info

Product

Resources

About