Volumetric-modulated Arc Therapy in Head and Neck Radiotherapy: A Planning Comparison using Simultaneous Integrated Boost for Nasopharynx and Oropharynx Carcinoma

Johnston, Melissa P.; Clifford, Steven C; Bromley, Regina; Back, Michael; Oliver, Lawrence K.; Eade, Thomas

doi:10.1016/j.clon.2011.02.002

Cited by 76 publications

(64 citation statements)

References 24 publications

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“…As in the prostate VMAT planning studies, a universal finding in these studies was the reduction in MU (up to 46%) with VMAT plans compared with fixed field IMRT [91][92][93]. Many of the above studies used seven to nine fields in their fixed field IMRT plans which used a larger number of MUs compared with the five-field plans [91,92,95].…”

Section: Head and Neck Cancermentioning

confidence: 93%

“…Integral doses to the body were also lower in the VMAT plans by an average of 7% compared with the fixed field IMRT plans. A more recent planning study comparing VMAT with fixed field IMRT (SW) in nasopharyngeal and oropharyngeal cancer confirmed improved sparing of the contralateral parotid glands with comparable PTV coverage between the two techniques [93].…”

Section: Head and Neck Cancermentioning

confidence: 99%

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Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Teoh

Clark²,

Wood³

et al. 2011

BJR

578

440

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ABSTRACT. Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites.

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Section: Head and Neck Cancermentioning

confidence: 93%

Section: Head and Neck Cancermentioning

confidence: 99%

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Teoh

Clark²,

Wood³

et al. 2011

BJR

578

440

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“…RapidArc has been compared with IMRT for a number of sites and malignancies commonly treated by IMRT, including brain, head and neck, prostate, anal canal, and cervical uterine, and its advantages in target coverage, treatment-time efficiency, and organs at risk (OAR) sparing have been demonstrated [5][6][7][8][9][10]. CSI, on the other hand, represents a challenging site where treatment is still predominantly done with 3DCRT because of a lack of a systematic procedure for dealing with the disease using VMAT.…”

Section: Introductionmentioning

confidence: 99%

Volumetric modulated arc therapy planning method for supine craniospinal irradiation

Chen¹,

Chen²,

Atwood³

et al. 2012

J Radiat Oncol

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Background The purpose of this study is to propose a volumetric modulated arc therapy (VMAT) treatment planning technique for supine craniospinal irradiation (CSI) in order to improve dose conformity and homogeneity, as well as the reliability of the matching of abutting fields. Methods and materials CT datasets of a 9-year-old child and a 24-year-old adult treated with supine CSI were identified. The planning target volume (PTV) was contoured to include the whole contents of the brain and spinal canal with a uniform margin of 5 mm. RapidArc plans were generated with two partial arcs covering the brain and the superior portion of the spinal cord and a single partial arc covering the remaining inferior portion of the spinal cord. Conformity and heterogeneity indexes (CI and HI) and organs at risk (OAR) dose-volume histograms were evaluated. The effect of treatment inaccuracy was simulated with intentional patient shifts of ±3 mm. Results The CI for the pediatric and adult cases was 1.0 and 0.99, respectively, and the HI for the two cases was 12.7 and 11.8 %, respectively. The mean dose to the PTV was 102.5 and 102.1 %, respectively, while the mean doses to the OARs were all low. The simulated ±3-mm shift in patient position generated an error of less than ±10 % of the calculated dose in the spinal cord. Conclusions VMAT CSI was able to achieve highly conformal and homogeneous dose distributions, with minor doses to the surrounding normal tissues. Setup errors of ±3 mm were shown to have little effect on the intended dose distribution.

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“…The use of VMAT in head and neck treatments may offer a combination of reduced treatment time, better organ‐at‐risk (OAR) sparing, or increased target dose conformality compared to other treatment types 2 , 3 , 4 , 5 . Many head and neck treatment plans include regional lymph nodes in the supraclavicular area.…”

Section: Introductionmentioning

confidence: 99%

Effect of interfractional shoulder motion on low neck nodal targets for patients treated using volumetric‐modulated arc therapy (VMAT)

Casey

Wong

Tung

2015

J Applied Clin Med Phys

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VMAT is an important tool in the treatment of head and neck cancers, many of which also require treatment to the supraclavicular lymph nodes. However, full VMAT arcs treating this nodal region necessarily cause entrance beam to pass through patients' shoulders. Thus, interfractional variations in shoulder position may cause unwanted dose perturbations. To assess this possibility, six patients undergoing treatment at our institution for head and neck cancers with associated supraclavicular lymph node treatment were imaged with in‐room CT‐on‐rails during the course of their treatments. This allowed for the establishment of a true record of the actual shoulder position during selected treatment fractions. Then, a full VMAT plan and a plan with VMAT arcs superior to the shoulder and a static anteroposterior field inferiorly were copied onto the patients' weekly image sets. The average one‐dimensional shoulder motion was generally within 10 mm of the simulated position, with some notable exceptions. The standard deviation in week‐to‐week shoulder position relative to simulation was 4.3 mm and 4.2 mm in the SI and AP dimensions, respectively. The average nodal target mean dose across all fractions sampled was within 5% of planned for all patients and both plans. Similarly, the average D95 for the nodal target was within 5% of planned across all fractions sampled, with the single exception of the full VMAT plan for one patient. In most cases, the standard deviation in both target mean dose and D95 was smaller with the VMAT+static AP field plan than it was with the full VMAT plan.PACS number: 87.55.‐x

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Volumetric-modulated Arc Therapy in Head and Neck Radiotherapy: A Planning Comparison using Simultaneous Integrated Boost for Nasopharynx and Oropharynx Carcinoma

Cited by 76 publications

References 24 publications

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Volumetric modulated arc therapy planning method for supine craniospinal irradiation

Effect of interfractional shoulder motion on low neck nodal targets for patients treated using volumetric‐modulated arc therapy (VMAT)

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