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Title: Continuous Arc Rotation of the Couch Therapy for the Delivery of Accelerated Partial Breast Irradiation: A Treatment Planning Analysis

Abstract

Purpose: We present a novel form of arc therapy: continuous arc rotation of the couch (C-ARC) and compare its dosimetry with three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT) for accelerated partial breast irradiation (APBI). C-ARC, like VMAT, uses a modulated beam aperture and dose rate, but with the couch, not the gantry, rotating. Methods and Materials: Twelve patients previously treated with APBI using 3D-CRT were replanned with (1) C-ARC, (2) IMRT, and (3) VMAT. C-ARC plans were designed with one medial and one lateral arc through which the couch rotated while the gantry was held stationary at a tangent angle. Target dose coverage was normalized to the 3D-CRT plan. Comparative endpoints were dose to normal breast tissue, lungs, and heart and monitor units prescribed. Results: Compared with 3D-CRT, C-ARC, IMRT, and VMAT all significantly reduced the ipsilateral breast V50% by the same amount (mean, 7.8%). Only C-ARC and IMRT plans significantly reduced the contralateral breast maximum dose, the ipsilateral lung V5Gy, and the heart V5%. C-ARC used on average 40%, 30%, and 10% fewer monitor units compared with 3D-CRT, IMRT, and VMAT, respectively. Conclusions: C-ARC provides improved dosimetry and treatment efficiency, which should reduce themore » risks of toxicity and secondary malignancy. Its tangent geometry avoids irradiation of critical structures that is unavoidable using the en face geometry of VMAT.« less

Authors:
; ; ;  [1];  [1]
  1. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)
Publication Date:
OSTI Identifier:
21587582
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2010.03.004; PII: S0360-3016(10)00401-3; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DOSIMETRY; HAZARDS; HEART; IRRADIATION; LUNGS; MAMMARY GLANDS; NEOPLASMS; RADIATION DOSES; RADIOTHERAPY; ROTATION; TOXICITY; BODY; CARDIOVASCULAR SYSTEM; DISEASES; DOSES; GLANDS; MEDICINE; MOTION; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RESPIRATORY SYSTEM; THERAPY

Citation Formats

Shaitelman, Simona F, Kim, Leonard H, Di, Yan, Martinez, Alvaro A, Vicini, Frank A., E-mail: fvicini@beaumont.edu, and Grills, Inga S. Continuous Arc Rotation of the Couch Therapy for the Delivery of Accelerated Partial Breast Irradiation: A Treatment Planning Analysis. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.03.004.
Shaitelman, Simona F, Kim, Leonard H, Di, Yan, Martinez, Alvaro A, Vicini, Frank A., E-mail: fvicini@beaumont.edu, & Grills, Inga S. Continuous Arc Rotation of the Couch Therapy for the Delivery of Accelerated Partial Breast Irradiation: A Treatment Planning Analysis. United States. https://doi.org/10.1016/j.ijrobp.2010.03.004
Shaitelman, Simona F, Kim, Leonard H, Di, Yan, Martinez, Alvaro A, Vicini, Frank A., E-mail: fvicini@beaumont.edu, and Grills, Inga S. 2011. "Continuous Arc Rotation of the Couch Therapy for the Delivery of Accelerated Partial Breast Irradiation: A Treatment Planning Analysis". United States. https://doi.org/10.1016/j.ijrobp.2010.03.004.
@article{osti_21587582,
title = {Continuous Arc Rotation of the Couch Therapy for the Delivery of Accelerated Partial Breast Irradiation: A Treatment Planning Analysis},
author = {Shaitelman, Simona F and Kim, Leonard H and Di, Yan and Martinez, Alvaro A and Vicini, Frank A., E-mail: fvicini@beaumont.edu and Grills, Inga S},
abstractNote = {Purpose: We present a novel form of arc therapy: continuous arc rotation of the couch (C-ARC) and compare its dosimetry with three-dimensional conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric-modulated arc therapy (VMAT) for accelerated partial breast irradiation (APBI). C-ARC, like VMAT, uses a modulated beam aperture and dose rate, but with the couch, not the gantry, rotating. Methods and Materials: Twelve patients previously treated with APBI using 3D-CRT were replanned with (1) C-ARC, (2) IMRT, and (3) VMAT. C-ARC plans were designed with one medial and one lateral arc through which the couch rotated while the gantry was held stationary at a tangent angle. Target dose coverage was normalized to the 3D-CRT plan. Comparative endpoints were dose to normal breast tissue, lungs, and heart and monitor units prescribed. Results: Compared with 3D-CRT, C-ARC, IMRT, and VMAT all significantly reduced the ipsilateral breast V50% by the same amount (mean, 7.8%). Only C-ARC and IMRT plans significantly reduced the contralateral breast maximum dose, the ipsilateral lung V5Gy, and the heart V5%. C-ARC used on average 40%, 30%, and 10% fewer monitor units compared with 3D-CRT, IMRT, and VMAT, respectively. Conclusions: C-ARC provides improved dosimetry and treatment efficiency, which should reduce the risks of toxicity and secondary malignancy. Its tangent geometry avoids irradiation of critical structures that is unavoidable using the en face geometry of VMAT.},
doi = {10.1016/j.ijrobp.2010.03.004},
url = {https://www.osti.gov/biblio/21587582}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 80,
place = {United States},
year = {Fri Jul 01 00:00:00 EDT 2011},
month = {Fri Jul 01 00:00:00 EDT 2011}
}