Dosimetric Comparison of Static Intensity Modulated Radiotherapy, Dynamic Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy for Thoracic Esophageal Cancer: A Single Institutional Experience

2020 ◽  
Vol 10 (3) ◽  
pp. 628-632
Author(s):  
Ruihao Wang ◽  
Qingxing Zeng ◽  
Songgui Luo ◽  
Guohui Shen ◽  
Ping Li ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Statistical Significance ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Planning System ◽  
Treatment Planning System ◽  
Thoracic Esophageal Cancer ◽  
Intensity Modulated ◽  
Arc Therapy ◽  
Delivery Efficiency

The aim of this study was to evaluate the dosimetric variations of static intensity-modulated radiotherapy (sIMRT), dynamic intensity-modulated radiotherapy (dIMRT) and volumetric modulated arc therapy (VMAT) for thoracic esophageal cancer (EC). Ten patients with pathologically-confirmed EC were randomly selected. The Monaco 5.11 treatment planning system was used to design six radiotherapy plans, namely sIMRT with 5 fixedfields (S5) and 7 fixed-fields (S7), dIMRT with 5 fixed-fields (D5) and 7 fixed-fields (D7) and VMAT plan with single arc (VMAT1) and double arc (VMAT2), respectively. The dosimetric parameters were compared among six different plans. The dose to target volumes met the clinical prescription requirements in all six plans. The D5 plan had the lowest dose exposed to the whole lungs, except for V5, which was only 1.7% higher than that in the D7 plan. The low dose to lungs (V5 and V10) in VMAT plans (VMAT1 and VMAT2) were higher than in IMRT plans, but the statistical differences were significant (P < 0.05) only in comparison with dynamic IMRT plans (D5 and D7). The V20 and V30 of lungs in VMAT2 plan were also higher than that in other plans, but the statistical differences were significant (P < 0.05) only in comparison with D5 plan. The doses delivered to the spinal cord and heart showed no statistical significance (P > 0.05). The monitor units (MUs) and treatment time (TT) significantly increased with the increasing number of fields in the same kind of fixed-fields IMRT plans (S5 vs. S7; D5 vs. D7). The MUs in VMAT plans, especially in VMAT2, increased significantly (P < 0.05) when compared with sIMRT and 5-fields dIMRT plans, respectively. VMAT1 plan had the shortest TT and the highest delivery efficiency. For thoracic esophageal cancer, the D5 plan can shorten the TT and improve the delivery efficiency while meeting the dosimetric requirements and sparing the lungs. VMAT can significantly reduce the TT, but at the expense of increasing the dose to lower-dose regions of lungs, which means VMAT plan may not shows obvious dose advantage for thoracic esophageal cancer.

scholarly journals Monte Carlo-Based Dose Calculation in Postprostatectomy Image-Guided Intensity Modulated Radiotherapy: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Ashley Rankine ◽  
Kirsty Turnbull ◽  
Stuart Greenham ◽  
Thomas P. Shakespeare ◽  
Justin Westhuyzen ◽  
...  
Keyword(s):  
Pilot Study ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Dose Calculation ◽  
Target Volume ◽  
Planning System ◽  
Treatment Planning System ◽  
Intensity Modulated ◽  
Arc Therapy ◽  
Step And Shoot

Step-and-shoot (S&S) intensity-modulated radiotherapy (IMRT) using the XiO treatment planning system (TPS) has been routinely used for patients receiving postprostatectomy radiotherapy (PPRT). After installing the Monaco, a pilot study was undertaken with five patients to compare XiO with Monaco (V2.03) TPS for PPRT with respect to plan quality for S&S as well as volumetric-modulated arc therapy (VMAT). Monaco S&S showed higher mean clinical target volume (CTV) coverage (99.85%) than both XiO S&S (97.98%, P = 0.04) and Monaco VMAT (99.44, P = 0.02). Rectal V60Gy volumes were lower for Monaco S&S compared to XiO (46.36% versus 58.06%, P = 0.001) and Monaco VMAT (46.36% versus 54.66%, P = 0.02). Rectal V60Gy volume was lowest for Monaco S&S and superior to XiO (mean 19.89% versus 31.25%, P = 0.02). Rectal V60Gy volumes were lower for Monaco VMAT compared to XiO (21.09% versus 31.25%, P = 0.02). Other organ-at-risk (OAR) parameters were comparable between TPSs. Compared to XiO S&S, Monaco S&S plans had fewer segments (78.6 versus 116.8 segments, P = 0.02), lower total monitor units (MU) (677.6 MU versus 770.7 MU, P = 0.01), and shorter beam-on times (5.7 min versus 7.6 min, P = 0.03). This pilot study suggests that Monaco S&S improves CTV coverage, OAR doses, and planning and treatment times for PPRT.

scholarly journals Comparison of Dosimetric Gains Provided by Intensity-Modulated Radiotherapy, Volume-Modulated Arc Therapy, and Helical Tomotherapy for High-Grade Glioma

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Pei Liu ◽  
Gui Liu ◽  
Guihua Wang ◽  
Weibing Zhou ◽  
Yangqing Sun ◽  
...  
Keyword(s):  
At Risk ◽  
Helical Tomotherapy ◽  
Intensity Modulated Radiotherapy ◽  
High Grade Glioma ◽  
The Other ◽  
Planning System ◽  
Treatment Planning System ◽  
High Grade ◽  
Intensity Modulated ◽  
Arc Therapy

Purpose. Because of the poor prognosis for high-grade glioma (HGG) patients, it is important to increase the dose of the tumor to improve the efficacy while minimizing the dose of organs at risk (OARs). Thus, we evaluated the potential dosimetric gains of helical tomotherapy (HT) versus intensity-modulated radiotherapy (IMRT) or volume-modulated arc therapy (VMAT) for high-grade glioma (HGG). Methods. A total of 42 HGG patients were retrospectively selected who had undergone helical tomotherapy; then, IMRT and VMAT plans were generated and optimized for comparison after contouring crucial neuronal structures for neurogenesis and neurocognitive function. IMRT and VMAT were optimized with the Eclipse treatment planning system (TPS) (Version 11.0.31) and HT using TomoTherapy Hi-Art Software (Version 2.0.7) (Accuray, Madison, WI, USA). All three techniques were optimized for simultaneously delivering 60 Gy to planning target volume (PTV) 1 and 50-54 Gy to PTV2. We also analyzed the homogeneity index (HI) and conformity index (CI) of PTVs and organ at risk (OAR) sparing. Results. There was no significant difference in the PTV coverage among IMRT, VMAT, or HT. As for the HI, HT plans (PTV1 HI: 0.09±0.03, PTV2 HI: 0.17±0.05) had the best homogeneity when compared to IMRT plans (PTV1 HI: 0.10±0.04, PTV2 HI: 0.18±0.04) and VMAT plans (PTV1 HI: 0.11±0.03, PTV2 HI: 0.20±0.03). The CI value of HT (PTV1 CI: 0.98±0.03, PTV2: 0.98±0.05) was closest to the optimal value. Except for the IMRT and VMAT groups, there were statistically significant differences between the other two groups of the CI values in both PTV1 and PTV2. The other comparison values were statistically significant except for the optic nerve, and VMAT had the best sparing of the optic chiasm. The mean and max doses of OARs declined significantly in HT. Conclusions. For high-grade glioma patients, HT had superior outcomes in terms of PTV coverage and OAR sparing as compared with IMRT/VMAT.

scholarly journals Volumetric Modulated Arc Radiotherapy for Early Stage Non-Small-Cell Lung Carcinoma: Is It Better Than the Conventional Static Beam Intensity Modulated Radiotherapy?

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Vincent Wing Cheung Wu ◽  
Man In Pun ◽  
Cho Pan Lam ◽  
To Wing Mok ◽  
Wah Wai Mok
Keyword(s):  
Early Stage ◽  
Small Cell Lung Carcinoma ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Intensity Modulated ◽  
Significant Difference ◽  
Arc Therapy

This study compared the performance of volumetric modulated arc therapy (VMAT) techniques: single arc volumetric modulated arc therapy (SA-VMAT) and double arc volumetric modulated arc therapy (DA-VMAT) with the static beam conventional intensity modulated radiotherapy (C-IMRT) for non-small-cell lung carcinoma (NSCLC). Twelve stage I and II NSCLC patients were recruited and their planning CT with contoured planning target volume (PTV) and organs at risk (OARs) was used for planning. Using the same dose constraints and planning objectives, the C-IMRT, SA-VMAT, and DA-VMAT plans were optimized. C-IMRT consisted of 7 static beams, while SA-VMAT and DA-VMAT plans consisted of one and two full gantry rotations, respectively. No significant difference was found among the three techniques in target homogeneity and conformity. Mean lung dose in C-IMRT plan was significantly lower than that in DA-VMAT plan P=0.04. The ability of OAR sparing was similar among the three techniques, with no significant difference in V20, V10, or V5 of normal lungs, spinal cord, and heart. Less MUs were required in SA-VMAT and DA-VMAT. Besides, SA-VMAT required the shortest beam on time among the three techniques. In treatment of early stage NSCLC, no significant dosimetric superiority was shown by the VMAT techniques over C-IMRT and DA-VMAT over SA-VMAT.

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