Dose verification of intensity-modulated arc therapy using an ERGO++ treatment planning system and Elekta internal multileaf collimators for prostate cancer treatment

AbstractBackgroundAccurate three-dimensional dosimetry is essential in modern radiotherapy techniques such as volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT). In this research work, the PRESAGE® dosimeter was used as quality assurance (QA) tool for VMAT planning for head and neck (H&N) cancer.Material and methodComputer tomography (CT) scans of an Image Radiation Oncology Core (IROC) H&N anthropomorphic phantom with both IROC standard insert and PRESAGE® insert were acquired separately. Both CT scans were imported into the Pinnacle (9.4 version) TPS for treatment planning, where the structures [planning target volume (PTV), organs at risk) and thermoluminescent detectors (TLDs) were manually contoured and used to optimise a VMAT plan. Treatment planning was done using VMAT (dual arc: 182°–178°, 178°–182°). Beam profile comparisons and gamma analysis were used to quantify agreement with film, PRESAGE® measurement and treatment planning system (TPS) calculated dose distribution.ResultsThe average ratio of TLD measured to calculated doses at the four PTV locations in the H&N phantom were between 0·95 to 0·99 for all three VMAT deliveries. Dose profiles were taken along the left–right, the anterior–posterior and superior–inferior axes, and good agreement was found between the PRESAGE® and Pinnacle profile. The mean value of gamma results for three VMAT deliveries in axial and sagittal planes were found to be 94·24 and 93·16% when compared with film and Pinnacle, respectively. The average values comparing the PRESAGE® results and dose values calculated on Pinnacle were observed to be 95·29 and 94·38% in the said planes, respectively, using a 5%/3 mm gamma criteria.ConclusionThe PRESAGE® dose measurements and calculated dose of pinnacle show reasonable agreement in both axial and sagittal planes for complex dual arc VMAT treatment plans. In general, the PRESAGE® dosimeter is found to be a feasible QA tool of VMAT plan for H&N cancer treatment.

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PROPERTY OF VOLUMETRIC MODULATED ARC THERAPY (VMAT) FOR PROSTATE CANCER USING ELEKTA SYNERGY AND ERGO++ TREATMENT PLANNING SYSTEM

Radiotherapy and Oncology ◽

10.1016/s0167-8140(12)73167-5 ◽

2009 ◽

Vol 92 ◽

pp. S216

Author(s):

A. Haga ◽

K. Nakagawa ◽

K. Shiraishi ◽

S. Itoh ◽

S. Kida ◽

...

Keyword(s):

Prostate Cancer ◽

Treatment Planning ◽

Volumetric Modulated Arc Therapy ◽

Planning System ◽

Treatment Planning System ◽

Arc Therapy

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Comparison of dose distribution between intensity modulated radiation therapy and dynamic arc therapy in and out-of-field for prostate cancer treatment plan

Physica Medica ◽

10.1016/j.ejmp.2013.08.121 ◽

2013 ◽

Vol 29 ◽

pp. e39

Author(s):

A. Ben Abdennebi ◽

G. Auzac ◽

J. Chavaudra ◽

M. Besbes ◽

D. Llanas ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Cancer Treatment ◽

Dose Distribution ◽

Treatment Plan ◽

Intensity Modulated Radiation Therapy ◽

Prostate Cancer Treatment ◽

Intensity Modulated ◽

Arc Therapy

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Multi-criteria optimization for planning volumetric-modulated arc therapy for prostate cancer

PLoS ONE ◽

10.1371/journal.pone.0257216 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257216

Author(s):

Jongmoo Park ◽

Jaehyeon Park ◽

Sean Oh ◽

Ji Woon Yea ◽

Jeong Eun Lee ◽

...

Keyword(s):

Prostate Cancer ◽

Treatment Planning ◽

Volumetric Modulated Arc Therapy ◽

Planning System ◽

Treatment Planning System ◽

Target Coverage ◽

Arc Therapy ◽

Femoral Heads ◽

Treatment Volume ◽

Dose Constraints

We aimed to compare the volumetric-modulated arc therapy (VMAT) plans with or without multi-criteria optimization (MCO) on commercial treatment-planning systems (Eclipse, Varian Medical System, Palo Alto, CA, USA) for patients with prostate cancer. We selected 25 plans of patients with prostate cancer who were previously treated on the basis of a VMAT plan. All plans were imported into the Eclipse Treatment Planning System version 15.6, and re-calculation and re-optimization were performed. The MCO plan was then generated. The dosimetric quality of the plans was evaluated using dosimetric parameters and dose indices that account for target coverage and sparing of the organs at risk (OARs). We defined the rectum, bladder, and bilateral femoral heads. The VMAT-MCO plan offers an improvement of gross treatment volume coverage with increased minimal dose and reduced maximal dose. In the planning treatment volume, the Dmean and better gradient, homogeneity, and conformity indexes improved despite the increasing hot and cold spots. When implemented through the MCO plan, a steeper fall off the adjacent OARs in the overlap area was achieved to obtain lower dose parameters. MCO generated better sparing of the rectum and bladder through a tradeoff of the increasing dose to the bilateral femoral heads within the tolerable dose constraints. Compared with re-optimization and re-calculation, respectively, significant dose reductions were observed in the bladder (241 cGy and 254 cGy; p<0.001) and rectum (474 cGy and 604 cGy, p<0.001) with the MCO. Planning evaluation and dosimetric measurements showed that the VMAT-MCO plan using visualized navigation can provide sparing of OAR doses without compromising the target coverage in the same OAR dose constraints.

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