Hybrid volumetric modulated arc therapy for chest wall irradiation: For a good plan, get the right mixture

2018 ◽  
Vol 52 ◽  
pp. 86-92 ◽  
Author(s):  
Karunakaran Balaji ◽  
Poonam Yadav ◽  
Sitaraman BalajiSubramanian ◽  
Chandrasekaran Anu Radha ◽  
Velayudham Ramasubramanian
Keyword(s):  
Chest Wall ◽  
Volumetric Modulated Arc Therapy ◽  
Arc Therapy ◽  
Good Plan ◽  
The Right

Feasibility of Left-sided Chest Wall Irradiation with Volumetric Modulated Arc Therapy

2010 ◽  
Vol 78 (3) ◽  
pp. S226-S227
Author(s):  
S. Thirumalai Swamy ◽  
V. Subramanian ◽  
M. Kathirvel ◽  
G. Arun ◽  
S. Chilukuri ◽  
...  
Keyword(s):  
Chest Wall ◽  
Volumetric Modulated Arc Therapy ◽  
Arc Therapy

Trajectory modulated arc therapy using quasi-continuous couch motion layered on top of volumetric modulated arc therapy in left breast and chest wall irradiation: a feasibility study

2017 ◽  
Vol 16 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Biplab Sarkar ◽  
Anirudh Pradhan
Keyword(s):  
Chest Wall ◽  
Organs At Risk ◽  
Treatment Plan ◽  
Volumetric Modulated Arc Therapy ◽  
Left Breast ◽  
Left Chest ◽  
Heart Dose ◽  
Arc Therapy ◽  
Prescription Dose ◽  
The Difference

AbstractAimTo investigate the dosimetric advantage of quasi-continuous couch motion-enabled trajectory modulated arc radiotherapy therapy (TMAT) over the coplanar tangential partial arcs volumetric modulated arc radiotherapy (VMAT) for treating left breast and chest wall patients.MethodTreatment plans of 43 patients who received radiotherapy for left breast (17) or for left chest wall (26) using coplanar partial tangential arcs VMAT (reference plan) were considered for this study. For each patient, in addition to the treatment plan, a TMAT plan was also generated using quasi-continuous couch rotation. The TMAT plan consisted of original two 30° tangential arc beams and two supplementary beams having a couch rotation of ±10°, ±20° and ±30°, respectively. The difference in PTV volume coverage (PTV V95%) between TMAT plan and VMAT plan was calculated for all the cases and normalised to the plan’s prescription dose. Similarly, differences in PTV_V105% and several dose-volume parameters related to organs at risk (OAR) were also computed and tabulated.ResultTMAT shows an increment in the PTV dose coverage V95% with respect to reference plan by 4·7±2·5% when averaged overall prescription dose levels. Mean PTV dose (averaged overall prescription levels) for reference and TMAT plan was 4638·6±423·8 and 4793·5±447·2 cGy, respectively, and statistically insignificant (p=0·06). However mean PTV_V105% values for TMAT and for reference plans were 6·7±4·8 and 7·2±5·2%, respectively, and were not statistically different (p=0·85). Mean heart dose in TMAT was less than in VMAT plans, but not significantly. As regarding D1% to heart, TMAT plan was again found to be better with a mean difference of 137·1 cGy over VMAT plan. Other parameters evaluated were: mean dose and D1% to contralateral breast, and V20 Gy and V5 Gy for lung.ConclusionTMAT plans were found to be better than VMAT plans in terms of PTV coverage and D1% for heart. For evaluated dose parameters apart from PTV coverage and D1% to the heart, no significant differences were observed. Thus, TMAT plans yielded better dose distribution in terms of PTV dose coverage, hot spots and OAR doses.

scholarly journals Dosimetric Comparison of Volumetric Modulated Arc Therapy, Static Field Intensity Modulated Radiation Therapy, and 3D Conformal Planning for the Treatment of a Right-Sided Reconstructed Chest Wall and Regional Nodal Case

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Vishruta A. Dumane ◽  
Margie A. Hunt ◽  
Sheryl Green ◽  
Yeh-Chi Lo ◽  
Richard L. Bakst
Keyword(s):  
Chest Wall ◽  
Treatment Time ◽  
Treatment Plan ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Static Field ◽  
Target Coverage ◽  
Delivery Method ◽  
Intensity Modulated ◽  
Arc Therapy

We compared 3D conformal planning, static field intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT) to investigate the suitable treatment plan and delivery method for a right-sided reconstructed chest wall and nodal case. The dose prescribed for the reconstructed chest wall and regional nodes was 50.4 Gy. Plans were compared for target coverage and doses of the lungs, heart, contralateral breast, and healthy tissue. All plans achieved acceptable coverage of the target and IMNs. The best right lung sparing achieved with 3D was a V20 Gy of 31.09%. Compared to it, VMAT reduced the same by 10.85% and improved the CI and HI over 3D by 18.75% and 2%, respectively. The ipsilateral lung V5 Gy to V20 Gy decreased with VMAT over IMRT by as high as 17.1%. The contralateral lung V5 Gy was also lowered with VMAT compared to IMRT by 16.22%. The MU and treatment beams were lowered with VMAT over IMRT by 30% and 10, respectively, decreasing the treatment time by >50%. VMAT was the treatment plan and delivery method of choice for this case due to a combination of improved lung sparing and reduced treatment time without compromising target coverage.

Dosimetric comparison of constant dose rate volumetric modulated arc therapy (CDR-VMAT) and intensity-modulated radiation therapy (IMRT) for gallbladder cancer

2020 ◽  
pp. 1-6
Author(s):  
Varsha R. Gedam ◽  
Anirudh Pradhan
Keyword(s):  
Gallbladder Cancer ◽  
Left Kidney ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Treatment Delivery ◽  
Significant Difference ◽  
Arc Therapy ◽  
Constant Dose ◽  
The Mean ◽  
The Right

Abstract Aim: To study the feasibility of constant dose rate volumetric modulated arc therapy (CDR-VMAT) in radiotherapy for gallbladder cancer by comparing dosimetric parameter suggested by International Commission on Radiation Units and Measurements-83 (ICRU-83) with step and shoot intensity-modulated radiation therapy (SS IMRT). Methods: For this study, we selected 21 post-operative gallbladder cancer patients, which were treated with the IMRT technique from 2016 to 2019. For each patient, we generated SS IMRT plan and CDR-VMAT plan and were dosimetrically compared by parameters suggested by ICRU-83 for PTV. Homogeneity Index (HI) and Conformity Index (CI) were also calculated. For evaluation of Organ at Risk (OAR), we compared the mean doses, volume doses to the right kidney, left kidney, both kidneys combined, liver and max dose to the spinal cord. Monitor units (MUs) and treatment delivery time were also compared. Results: On comparing, we found that CDR-VMAT plans were highly conformed as CI and PCI (CI define by Paddick) were found more (0·98 ± 0·01 vs. 0·97 ± 0·03 and 0·86 ± 0·05 vs. 0·85 ± 0·05) than IMRT plans but not statistically significant. Better dose HI was found for IMRT plans with statistical significant difference (p < 0·001). The tumour coverage was found similar 98·24% and 97·83% for SS IMRT and CDR-VMAT, respectively. For D2%, the maximum dose to PTV was significantly lower in IMRT (p = 0·001). D50% and mean dose to PTV were also comparable to IMRT with no statistically significant difference. The OAR parameters were comparable in both the techniques. The mean doses and volume doses V10, V20 and V30 to the right kidney, left kidney and liver were also comparable with no significant difference (p > 0·05) was noted among them. However, the maximum dose to the spinal cord was significantly less in CDR-VMAT (21·1 Gy vs. 25·1Gy) than SS IMRT with p = 0·006. More MUs were associated with the CDR-VMAT technique, but shorter treatment delivery time than the IMRT technique. Conclusions: On dosimetric comparison of two treatment techniques, we conclude that CDR-VMAT can be a valid option in radiotherapy as it achieved highly conformed dose distribution, comparable tumour coverage and OAR sparing as IMRT technique for gallbladder cancer.

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