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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer
Radiotherapy and Oncology, Volume 93, No. 2, Year 2009
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Description
Introduction: Volumetric modulated arc therapy (VMAT), a complex treatment strategy for intensity-modulated radiation therapy, may increase treatment efficiency and has recently been established clinically. This analysis compares VMAT against established IMRT and 3D-conformal radiation therapy (3D-CRT) delivery techniques. Methods: Based on CT datasets of 9 patients treated for prostate cancer step-and-shoot IMRT, serial tomotherapy (MIMiC), 3D-CRT and VMAT were compared with regard to plan quality and treatment efficiency. Two VMAT approaches (one rotation (VMAT1x) and one rotation plus a second 200° rotation (VMAT2x)) were calculated for the plan comparison. Plan quality was assessed by calculating homogeneity and conformity index (HI and CI), dose to normal tissue (non-target) and D95% (dose encompassing 95% of the target volume). For plan efficiency evaluation, treatment time and number of monitor units (MU) were considered. Results: For MIMiC/IMRTMLC/VMAT2x/VMAT1x/3D-CRT, mean CI was 1.5/1.23/1.45/1.51/1.46 and HI was 1.19/1.1/1.09/1.11/1.04. For a prescribed dose of 76 Gy, mean doses to organs-at-risk (OAR) were 50.69 Gy/53.99 Gy/60.29 Gy/61.59 Gy/66.33 Gy for the anterior half of the rectum and 31.85 Gy/34.89 Gy/38.75 Gy/38.57 Gy/55.43 Gy for the posterior rectum. Volumes of non-target normal tissue receiving ≥70% of prescribed dose (53 Gy) were 337 ml/284 ml/482 ml/505 ml/414 ml, for ≥ 50% (38 Gy) 869 ml/933 ml/1155 ml/1231 ml/1993 ml and for ≥ 30% (23 Gy) 2819 ml/3414 ml/3340 ml/3438 ml /3061 ml. D95% was 69.79 Gy/70.51 Gy/71,7 Gy/71.59 Gy/73.42 Gy. Mean treatment time was 12 min/6 min/3.7 min/1.8 min/2.5 min. Conclusion: All approaches yield treatment plans of improved quality when compared to 3D-conformal treatments, with serial tomotherapy providing best OAR sparing and VMAT being the most efficient treatment option in our comparison. Plans which were calculated with 3D-CRT provided good target coverage but resulted in higher dose to the rectum. © 2009 Elsevier Ireland Ltd. All rights reserved.
Authors & Co-Authors
Wolff, Dirk
Germany, Mannheim
Universitätsklinikum Mannheim
Stieler, Florian
Germany, Mannheim
Universitätsklinikum Mannheim
Welzel, Grit
Germany, Mannheim
Universitätsklinikum Mannheim
Lorenz, Friedlieb
Germany, Mannheim
Universitätsklinikum Mannheim
Abo-Madyan, Yasser M.
Germany, Mannheim
Universitätsklinikum Mannheim
Egypt, Giza
Cairo University
Mai, Sabine
Germany, Mannheim
Universitätsklinikum Mannheim
Herskind, Carsten
Germany, Mannheim
Universitätsklinikum Mannheim
Polednik, Martin
Germany, Mannheim
Universitätsklinikum Mannheim
Steil, Volker
Germany, Mannheim
Universitätsklinikum Mannheim
Wenz, Frederik
Germany, Mannheim
Universitätsklinikum Mannheim
Lohr, Frank R.H.
Germany, Mannheim
Universitätsklinikum Mannheim
Statistics
Citations: 357
Authors: 11
Affiliations: 2
Identifiers
Doi:
10.1016/j.radonc.2009.08.011
Research Areas
Cancer
Health System And Policy