scholarly journals Dosimetric evaluation of three commercial radiotherapy planning systems for lung cancer and nasopharyngeal carcinoma cases

2020 ◽  
Author(s):  
Wan-jia Zheng ◽  
Ming-li Wang ◽  
Jun Zhang ◽  
Yi-mei Liu ◽  
Li Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Spinal Cord ◽  
Nasopharyngeal Carcinoma ◽  
Treatment Time ◽  
Maximum Dose ◽  
Organs At Risk ◽  
Radiotherapy Planning ◽  
Planning Systems ◽  
Significant Difference ◽  
Better Than

Abstract Purpose: To identify planning systems and techniques suitable for different sites tumors by analyzing dosimetric differences using three commercial radiotherapy planning systems: Tomotherapy, Monaco and Eclipse.Methods: We retrospectively analyzed 20 lung cancer and 8 nasopharyngeal carcinoma (NPC), and each patient plans were designed using the three systems. The dose distribution of the target and organs at risk (OARs) were compared, and monitor unit (MU) and treatment time were also evaluated.Results: For lung cancer, mean dose of PGTV, PTV1 and PTV2 in Monaco and Tomo plans were lower than Eclipse plan. PTV2 CI in Monaco and Eclipse plans were better than Tomo plans (p=0.002, p=0.022). Monaco and Tomo plans were better than Eclipse plan regarding to mean dose and V15Gy of lungs; the lowest lungs V20Gy and V30Gy were provided by Tomo plan. The esophagus, heart and SpinalCord_03 dose were lowest in Monaco plan, and the maximum dose and V45Gy of SpinalCord_03 were 592.1cGy and 1.37% lower than Eclipse plan, respectively. For NPC, mean dose of PGTV, PTV1 and PTV2 in Eclipse plan were superior to Tomo plan (p=0.008, p=0.000, p=0.003); PTV2 V95% in Tomo plan was increased by 1.64% than Eclipse plan. There was no significant difference between Monaco and Eclipse plans. Tomo plan showed better spinal cord and brainstem protection, with spinal cord max dose 249.38cGy lower than Eclipse plan and 555cGy lower than Monaco plan, respectively.Conclusion: Although the three plans reflected their respective advantages in different aspects, in general, the Monaco plan (VMAT) was the best choice for lung cancer, and for the more advanced nasopharyngeal carcinoma, the Tomo plan (HT) was superior to the other two plans.

scholarly journals Dosimetric evaluation of three commercial radiotherapy planning systems for lung cancer and nasopharyngeal carcinoma cases

2020 ◽  
Author(s):  
Wan-jia Zheng ◽  
Ming-li Wang ◽  
Jun Zhang ◽  
Yi-mei Liu ◽  
Li Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Nasopharyngeal Carcinoma ◽  
Radiotherapy Planning ◽  
Planning Systems

Abstract The authors have withdrawn this preprint due to author disagreement.

scholarly journals Comparative study between Acuros XB algorithm and Anisotropic Analytical Algorithm in the case of heterogeneity for the treatment of lung cancer

2018 ◽  
Vol 24 (3) ◽  
pp. 115-119
Author(s):  
Mohammed El Adnani Krabch ◽  
Abdelouahed Chetaine ◽  
Abdelati Nourreddine ◽  
Fatim Zohra Er-Radi ◽  
Laila Baddouh
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Heterogeneous Media ◽  
Maximum Dose ◽  
Organs At Risk ◽  
Target Volume ◽  
Conformity Index ◽  
Acuros Xb ◽  
Significant Difference ◽  
The Impact

Abstract The aim of this study was to investigate the impact of heterogeneity on the dose calculation for two algorithms implemented in the TPS “Analytical Anisotropic Algorithm (AAA) and Acuros XB” and validated the use of Acuros XB algorithm in clinical routine. First, we compare the dose calculated by these algorithms and the dose measured at the given point P, which is found after heterogeneity insert. Second, we extend our work on clinical cases that present a complex heterogeneity. By evaluating the impact of the choice of the algorithm on the dose coverage of the tumor, and the dose received by the organs at risk for 20 patients affected by lung cancer. The result of our phantom study showed a good agreement with several studies that showed the superiority of the Acuros XB over the AAA in predicting dose when it concerns heterogeneous media. The treatment plans for 20 lung cancers were calculated by two algorithms AAA and Acuros XB, the results show a statistical significant difference between algorithms for Homogeneity Index and the maximum dose of planning target volume (HI: 0.11±0.01 vs 0.05±0.01 p = 0.04; Dmax: 69.30±3.12 vs 68.51±2.64 p = 0.02). Instead, no statistically significant difference was observed for conformity index CI and mean dose (CI: 0.98±0.18 vs 0.99±0.14 p = 0.33; Dmean: 66.3±0.65 vs 66.10 ±0.61 p = 0.54). For organs at risk, the maximum dose for spinal cord, mean dose and D37 % of lung minus GTV (dose receiving 37% of lung volume) were found to be lower for AAA plans than Acuros XB and the differences were statistically significant (p<0.05). For the heart D33% and D67% were found to be higher for AAA plans than Acuros XB and the differences were statistically significant (p<0.05), but No difference was observed for D100% of the heart. The use of the AXB algorithm is suitable in the case of presence of heterogeneity, because it allows to have a better accuracy close to the Monte Carlo calculation.

scholarly journals The Influence of SSO on the Optimization Result of Nasopharynx Carcinoma Plan

2021 ◽  
Author(s):  
Xiaolong HUA ◽  
Jianhe YU ◽  
Lu WANG ◽  
Jiaqi DAI ◽  
Qun REN ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Organs At Risk ◽  
Planning System ◽  
Treatment Planning System ◽  
Target Area ◽  
Delivery Time ◽  
Parotid Glands ◽  
Similar Dose ◽  
Significant Difference ◽  
Better Than

Abstract PurposeTo study the influence of Monaco 5.4 treatment planning system (TPS) on the dosimetry of radiotherapy for nasopharynx carcinoma (NPC) under the condition of different segment shape optimization (SSO) times.MethodsFifteen patients with T3-4N0-2M0 stage nasopharyngeal carcinoma were enrolled, and each case was designed with SSO of 3, 5, 7 and 10 times respectively. The dose results of the target area and the major organs at risk (OAR) were statistically analyzed by DVH statistics; moreover, the isodose lines of 70Gy, 60Gy and 54Gy were intercepted at the same plane in the transverse, coronal and sagittal views and the segment shapes were compared at the angle of 30°, 120°, 240° and 330° in beam eye view (BEV); In addition, optimization time (OT), delivery time (DT), segments# and MU# were obtained and analyzed by optimization console; the plans were verified and analyzed by using ArcCheck phantom.ResultsFor target area D2, the results of the SSO7 group and the SSO10 group were similar and both better than those of SSO3 and SSO5 groups, and the D2 results of the SSO3 group were notable higher than those of the other three groups; for the major OARs, the results of the maximum dose of spinal cord, brain stem, and lens and the mean dose and V30 of parotid glands showed the same trend. It showed that SSO7 and SSO10 share similar dose results, too which are notable better than the similar dose results shared by SSO3 and SSO5; in the dose deprogram distribution of 70Gy, 60Gy and 54Gy, partial 70Gy dose spillover occurred in both groups SSO3 and SSO5 and it was more obvious in group SSO3. While there was a no significant dose spillover in group SSO7 and group SSO10; in the sub-field alignment comparison under the same angle, the alignment became more complicated and the sub-fields were smaller as the number of SSO increased; the results of segment#, MU# and plan delivery time between different SSO groups were slightly different, while the plan optimization time changed significantly. The difference between group SSO3 and group SSO10 was more than 500s; the results were compared in ArcCheck, there was no significant difference between the groups.ConclusionsThe user-defined SSO function of Monaco 5.4 TPS effectively balances the relationship between plan design efficiency and plan quality. When SSO is 7, it is better value for efficiency and quality in clinical radiotherapy for nasopharyngeal carcinoma.

scholarly journals Planning Lung Radiotherapy Incorporating Motion Freeze PET/CT Imaging

2018 ◽  
Vol 8 (9) ◽  
pp. 1583 ◽  
Author(s):  
Shih-Neng Yang ◽  
Wan-Chi Chiang ◽  
Kuei-Ting Chou ◽  
Geoffrey Zhang ◽  
Tzung-Chi Huang
Keyword(s):  
Lung Cancer ◽  
Spinal Cord ◽  
Maximum Dose ◽  
Organs At Risk ◽  
Three Dimensional ◽  
Intensity Modulated Radiotherapy ◽  
Standardized Uptake Value ◽  
Target Volume ◽  
Gated Radiotherapy ◽  
The Impact

Motion Freeze (MF), which integrates 100% of the signal of each respiratory phase in four-dimensional positron emission tomography (4D-PET) images and creates the MF-PET, is capable of eliminate the influences induced by respiratory motion and dispersing from three-dimensional PET (3D-PET) and 4D-PET images. In this study, the effectiveness of respiratory gated radiotherapy applying MF-PET (MF-Plan) in lung cancer patient was investigated and compared with three-dimensional intensity modulated radiotherapy (3D-Plan) and routine respiratory gated radiotherapy (4D-Plan) on the impact of target volume and dosimetry. Thirteen lung cancer patients were enrolled. The internal target volumes were generated with 40% of maximum standardized uptake value. The 3D-Plan, 4D-Plan, and MF-Plan were created for each patient to study the radiation to the targets and organs at risk. MF-Plans were associated with significant reductions in lung, heart, and spinal cord doses. The median reductions in lung V20, lung mean, heart mean doses, and spinal cord maximum dose compared with 3D-Plans were improved. When compared with 4D-Plans, the median reductions in lung V20, lung mean dose, heart mean dose, and spinal cord maximum dose were improved. Our results indicate that the MF-Plan may improve critical organ sparing in the lung, heart, and spinal cord, while maintaining high target coverage.

scholarly journals Quantitative and dosimetric analysis for treating synchronous bilateral breast cancer using two radiotherapy planning techniques

2021 ◽  
Vol 27 (3) ◽  
pp. 201-206
Author(s):  
Özlem Mermut ◽  
Aysun Ozsoy Ata ◽  
Didem Can Trabulus
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Organs At Risk ◽  
Bilateral Breast Cancer ◽  
Radiotherapy Planning ◽  
Conformity Index ◽  
Treatment Unit ◽  
Significant Difference ◽  
Synchronous Bilateral Breast Cancer ◽  
The Right

Abstract Objective: We compared mono-isocenter and dual-isocenter plans in synchronous bilateral breast cancer (SBBC), which is defined as tumours occurring simultaneously in both breasts, and evaluated the effects of these differences in plans on organs-at-risk (OARs). Materials and methods: We evaluated 10 women with early stage, nod negative (Tis-2N0M0) SBBC. The treatment dose was determined to be 50 Gy. We used mean dose and VXGy to evaluate the OARs. To evaluate the effectiveness of treatment plans, Homogeneity index (HI), conformity index (CI) and sigma index (SI) and monitor units (MU) of monoisocenter (MIT) and dual-isocenter (DIT) plans were compared. During bilateral breast planning, for the single-centre plan, the isocenter was placed at the center of both breasts at a depth of 3-4 cm. For the two-center plan, dual-isocenters were placed on the right and left breasts. Results: No significant difference between the techniques in terms of the scope of the target volume was observed. Statistically significant results were not achieved in MIT and DIT plans for OARs. Upon comparing MIT and DIT, the right-side monitor unit (MU) value in DIT (p = 0.011) was statistically significantly lower than that in MIT. Upon comparing right-left side MIT and DIT, the MU value (p = 0.028) was significantly lower in DIT than MIT. Conclusion: SBBC irradiation is more complex than unilateral breast radiotherapy. No significant difference between both techniques and OARs was observed. However, we recommend MIT as a priority technique due to the ability to protect OARs, ease of administration during treatment, and the fact that the patient stays in the treatment unit for a shorter period of time.

scholarly journals Transition from conformal to advanced radiotherapy techniques in treatment planning of gynecological cancer patients

2021 ◽  
pp. 77-77
Author(s):  
Borislava Petrovic ◽  
Olivera Ivanov ◽  
Milana Marjanovic ◽  
Jelena Licina ◽  
Ivan Gencel ◽  
...  
Keyword(s):  
At Risk ◽  
Cancer Patients ◽  
Maximum Dose ◽  
Organs At Risk ◽  
Gynecological Cancer ◽  
Conformal Radiation Therapy ◽  
Significant Difference ◽  
Treatment Plans ◽  
Radiation Induced ◽  
Risk Treatment

Background/ Aim. Transition from standard to highly conformal radiation therapy techniques, requires implementation of complex advanced dosimetry. The aim of the work was comparison of dosimetric parameters of 3DCRT and VMAT plan, as well as complications after treatment in relation to dosimetric parameters at gynecological cancer patients. Methods. Forty-nine gynecological cancer patients were included in the study. All patients were planned for 3D CRT, but due to unacceptable doses to organs at risk, treatment plans for IMRT or VMAT were generated for 21 patients. The patients were prescribed 50.4 Gy/28 fractions (4) and 45 Gy/25 fractions (45 patients). The coverage of PTV and doses to organs at risk were recorded. PTV margins were evaluated for both techniques according to the Van Herk formula. Results. ICRU 83 criteria were fulfilled in all 3DCRT /VMAT/IMRT plans providing optimal coverage of PTV. Doses to OARS: in average, the V45Gy in small bowel in IMRT/VMAT plans was four times smaller than the same of 3DCRT plans. The V45Gy of small bowels was in average 49.4cm3 in IMRT/VMAT plans, while in 3DCRT plans it was 211.6 cm3. In case of femoral head, significant reduction in V30Gy (10.8 % vs. 33.1%) and mean dose in case of IMRT/VMAT plans was recorded (30.4 Gy in 3DCRT vs 23.6 Gy). Rectum was planned with significantly lower dose in terms of V30Gy (79.5% vs 95.2%) in IMRT/VMAT plans. Bladder was better spared in VMAT plans in terms of V40Gy (51% vs. 91%), but maximum dose was higher in VMAT plans than in 3DCRT (50.1 Gy to 48.1 Gy in average). For all OARs there is statistically significant difference registered at p>0.05. Toxicities recorded in VMAT and 3DCRT patients include mainly radiation induced cystitis and enteritis. Patients treated with 3DCRT generally have longer recovery time. Homogeneity index was 0.11 for VMAT plans and 0.09 for 3DCRT plans. Conclusions. Analysis of dosimetric parameters revealed significant differences in normal tissue doses for same 3DCRT and VMAT patient, which confirmed necessity for implementation of advanced techniques for as many patients as possible.

scholarly journals A Comparative Study of Auto-contouring Softwares in Delineation of Organs at Risk in Lung Cancer and Rectal Cancer

2021 ◽  
Author(s):  
weijun chen ◽  
Cheng Wang ◽  
Wenming Zhan ◽  
Yongshi Jia ◽  
Fangfang Ruan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Rectal Cancer ◽  
Organs At Risk ◽  
Similarity Index ◽  
Slight Modification ◽  
Ct Images ◽  
Target Area ◽  
Ct Image ◽  
Significant Difference

Abstract Background:Radiotherapy requires the target area and the organs at risk to be contoured on the CT image of the patient. During the process of organs-at-Risk (OAR) of the chest and abdomen, the doctor needs to contour at each CT image. The delineations of large and varied shapes are time-consuming and laborious.This study aims to evaluate the results of two automatic contouring software on OAR definition of CT images of lung cancer and rectal cancer patients. Methods: The CT images of 15 patients with rectal cancer and 15 patients with lung cancer were selected separately, and the organs at risk were outlined by the same experienced doctor as references, and then the same datasets were automatically contoured based on AiContour®© (Manufactured by Linking MED, China) and Raystation®© (Manufactured by Raysearch, Sweden) respectively. Overlap index (OI), Dice similarity index (DSC) and Volume difference (DV) were evaluated based on the auto-contours, and independent-sample t-test analysis is applied to the results. Results: The results of AiContour®© on OI and DSC were better than that of Raystation®© with statistical difference. There was no significant difference in DV between the results of two software. Conclusions: With AiContour®©, auto-contouring results of most organs in the chest and abdomen are good, and with slight modification, it can meet the clinical requirements for planning. With Raystation®©, auto-contouring results in most OAR is not as good as AiContour®©, and only the auto-contouring results of some organs can be used clinically after modification.

Metastatic spinal cord compression secondary to lung cancer.

1992 ◽  
Vol 10 (11) ◽  
pp. 1781-1787 ◽  
Author(s):  
F Bach ◽  
N Agerlin ◽  
J B Sørensen ◽  
T B Rasmussen ◽  
P Dombernowsky ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Spinal Cord ◽  
Cell Carcinoma ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Metastatic Spinal Cord Compression ◽  
Rank Test ◽  
Log Rank Test ◽  
Significant Difference ◽  
Histologic Types

PURPOSE Metastatic spinal cord compression (MSCC) is a disabling complication to cancer, the optimal treatment for which is not settled. An analysis was performed for all patients with MSCC secondary to lung cancer in East Denmark from 1979 to 1988. PATIENTS AND METHODS The total series included 102 cases with small-cell carcinoma (SCLC; 40%), adenocarcinoma (ACL; 26%), squamous cell carcinoma (SQLC; 18%) and large-cell carcinoma (LCC; 9%). Symptoms, clinical presentations, and therapeutic results are described. RESULTS The outcome of treatment depended fundamentally on the patient's neurologic condition at the time of the diagnosis. All patients with SCLC who were able to walk at the time of MSCC remained ambulatory, whereas 15% of the nonambulatory SCLC patients regained walking ability. In non-SCLC, 95% of patients continued to be able to walk, whereas 22% regained the ability to walk. No major differences in the immediate outcome of treatment between the various histologic types of lung cancer and the different treatment modalities were observed; however, 82% of the patients with non-SCLC benefited from treatment with laminectomy followed by radiotherapy (RT) compared with either laminectomy (47%) or RT (39%) alone (P = .03, chi 2 test). The group of patients who were treated with laminectomy followed by RT had a better survival (median value, 3.5; range, 0 to 132 months) than patients who were treated with either laminectomy (median value, 1.5; range, 0 to 32 months) or RT (median value, 1; range, 0 to 59 months) alone (P = .03, log-rank test). No significant difference was observed in survival between the various histologic types of lung cancer (P = .18, log-rank test). CONCLUSION Despite a short survival, early diagnosis and immediate treatment is crucial because it may preserve the gait function in 97% of lung cancer patients who develop malignant spinal cord compression.

scholarly journals Automatic Planning for Nasopharyngeal Carcinoma Based on Progressive Optimization in RayStation Treatment Planning System

2020 ◽  
Vol 19 ◽  
pp. 153303382091571
Author(s):  
Yiwei Yang ◽  
Kainan Shao ◽  
Jie Zhang ◽  
Ming Chen ◽  
Yuanyuan Chen ◽  
...  
Keyword(s):  
At Risk ◽  
Nasopharyngeal Carcinoma ◽  
Organs At Risk ◽  
Planning System ◽  
Treatment Planning System ◽  
Conformity Index ◽  
Homogeneity Index ◽  
Automatic Planning ◽  
The Difference ◽  
Better Than

Objective: To evaluate and quantify the planning performance of automatic planning (AP) with manual planning (MP) for nasopharyngeal carcinoma in the RayStation treatment planning system (TPS). Methods: A progressive and effective design method for AP of nasopharyngeal carcinoma was realized through automated scripts in this study. A total of 30 patients with nasopharyngeal carcinoma with initial treatment was enrolled. The target coverage, conformity index (CI), homogeneity index (HI), organs at risk sparing, and the efficiency of design and execution were compared between automatic and manual volumetric modulated arc therapy (VMAT) plans. Results: The results of the 2 design methods met the clinical dose requirement. The differences in D95 between the 2 groups in PTV1 and PTV2 showed statistical significance, and the MPs are higher than APs, but the difference in absolute dose was only 0.21% and 0.16%. The results showed that the conformity index of planning target volumes (PTV1, PTV2, PTVnd and PGTVnx+rpn [PGTVnx and PGTVrpn]), homogeneity index of PGTVnx+rpn, and HI of PTVnd in APs are better than that in MPs. For organs at risk, the APs are lower than the MPs, and the difference was statistically significant ( P < .05). The manual operation time in APs was 83.21% less than that in MPs, and the computer processing time was 34.22% more. Conclusion: IronPython language designed by RayStation TPS has clinical application value in the design of automatic radiotherapy plan for nasopharyngeal carcinoma. The dose distribution of tumor target and organs at risk in the APs was similar or better than those in the MPs. The time of manual operation in the plan design showed a sharp reduction, thus significantly improving the work efficiency in clinical application.

Radiotherapy planning study comparing volumetric modulated arc therapy (VMAT) with intensity modulated radiotherapy (IMRT) in the treatment of bladder and pelvic lymph nodes.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 320-320
Author(s):  
Victoria Harris ◽  
Karole Warren-Oseni ◽  
Robert Anthony Huddart
Keyword(s):  
Low Dose ◽  
Treatment Time ◽  
Statistical Significance ◽  
Volumetric Modulated Arc Therapy ◽  
Radiotherapy Planning ◽  
Rank Test ◽  
Attractive Alternative ◽  
Planning Study ◽  
Significant Difference ◽  
3D Crt

320 Background: VMAT is increasingly used as an alternative to IMRT and has been shown to reduce treatment time and monitor units delivered. We report a radiotherapy (RT) planning study of bladder and pelvic lymph node (LN) RT comparing dosimetric outcomes of VMAT and IMRT techniques. Methods: 8 patients with/at high risk of LN+ bladder cancer were treated with bladder/pelvic LN IMRT. 4 clinical target volumes (CTVs) were defined: Whole bladder (CTV1), Pelvic LN (CTV2), Involved Bladder (CTV3) and Involved LNs (CTV4). Margins were applied to create 4 corresponding PTVs. IMRT plans were compared with VMAT plans in order to assess planning target volume (PTV) and organ at risk (OAR) coverage. The same PTV/OAR volumes and doses were used for each technique. Results: The mean dose statistics were compared for each dosimetric parameter for both techniques. The Wilcoxon signed-rank test was used to compare techniques with statistical significance assumed as p<0.05. Both techniques met prescription goals for PTV coverage. Comparison of conformity indices revealed no significant difference between techniques. VMAT achieved significantly better homogeneity in coverage of PTV2, although this finding was not replicated in the other PTVs (Table). Homogeneity index (HI) was defined as HI = 100x(D2-D98)/ Dp, where Dp = prescribed dose. VMAT resulted in significantly larger volumes of bowel (4.7%) and rectum (4.8%) receiving low dose radiation (15 Gy) than IMRT, although there was no significant difference seen at higher dose levels. Comparison with 3D conformal radiotherapy (3D-CRT) showed that both techniques resulted in a large reduction in bowel irradiation to 45Gy (IMRT = 123cc, VMAT = 145cc and 3D-CRT = 218cc). Conclusions: VMAT offers an attractive alternative to IMRT with similar conformality. Whilst increased low dose RT to OARs was seen with VMAT, it is of doubtful significance relative to the higher doses received by these structures. [Table: see text]

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