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Title: Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer

Abstract

Purpose: To quantify differences in treatment delivery efficiency and dosimetry between step-and-shoot intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT) for prostate treatment. Methods and Materials: Twenty-five prostate cancer patients were selected retrospectively for this planning study. Treatment plans were generated for: prostate alone (n = 5), prostate + seminal vesicles (n = 5), prostate + seminal vesicles + pelvic lymph nodes (n = 5), prostate bed (n = 5), and prostate bed + pelvic lymph nodes (n = 5). Target coverage, dose homogeneity, integral dose, monitor units (MU), and sparing of organs at risk (OAR) were compared across techniques. Time required to deliver each plan was measured. Results: The dosimetric quality of IMRT, VMAT, and HT plans were comparable for target coverage (planning target volume V95%, clinical target volume V100% all >98.7%) and sparing of organs at risk (OAR) for all treatment groups. Although HT resulted in a slightly higher integral dose and mean doses to the OAR, it yielded a lower maximum dose to all OAR examined. VMAT resulted in reductions in treatment times over IMRT (mean = 75%) and HT (mean = 70%). VMAT required 15-38% fewer monitor units than IMRT over allmore » treatment volumes, with the reduction per fraction ranging from 100-423 MU from the smallest to largest volumes. Conclusions: VMAT improves efficiency of delivery for equivalent dosimetric quality as IMRT and HT across various prostate cancer treatment volumes in the intact and postoperative settings.« less

Authors:
 [1];  [1];  [1];  [2];  [3];  [2];  [1];  [2]
  1. Department of Medical Physics, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)
  2. (Canada)
  3. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada)
Publication Date:
OSTI Identifier:
21587652
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 80; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2010.10.024; PII: S0360-3016(10)03445-0; 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; COMPUTERIZED TOMOGRAPHY; CT-GUIDED RADIOTHERAPY; DOSIMETRY; HAZARDS; INTEGRAL DOSES; LYMPH NODES; NEOPLASMS; PROSTATE; BODY; DIAGNOSTIC TECHNIQUES; DISEASES; DOSES; GLANDS; LYMPHATIC SYSTEM; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIATION DOSES; RADIOLOGY; RADIOTHERAPY; THERAPY; TOMOGRAPHY

Citation Formats

Davidson, Melanie T.M., E-mail: melanie.davidson@sunnybrook.ca, Blake, Samuel J., Batchelar, Deidre L., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Cheung, Patrick, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Mah, Katherine, and Department of Radiation Oncology, University of Toronto, Toronto, Ontario. Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.10.024.
Davidson, Melanie T.M., E-mail: melanie.davidson@sunnybrook.ca, Blake, Samuel J., Batchelar, Deidre L., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Cheung, Patrick, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Mah, Katherine, & Department of Radiation Oncology, University of Toronto, Toronto, Ontario. Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer. United States. doi:10.1016/j.ijrobp.2010.10.024.
Davidson, Melanie T.M., E-mail: melanie.davidson@sunnybrook.ca, Blake, Samuel J., Batchelar, Deidre L., Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Cheung, Patrick, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Mah, Katherine, and Department of Radiation Oncology, University of Toronto, Toronto, Ontario. Mon . "Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer". United States. doi:10.1016/j.ijrobp.2010.10.024.
@article{osti_21587652,
title = {Assessing the Role of Volumetric Modulated Arc Therapy (VMAT) Relative to IMRT and Helical Tomotherapy in the Management of Localized, Locally Advanced, and Post-Operative Prostate Cancer},
author = {Davidson, Melanie T.M., E-mail: melanie.davidson@sunnybrook.ca and Blake, Samuel J. and Batchelar, Deidre L. and Department of Radiation Oncology, University of Toronto, Toronto, Ontario and Cheung, Patrick and Department of Radiation Oncology, University of Toronto, Toronto, Ontario and Mah, Katherine and Department of Radiation Oncology, University of Toronto, Toronto, Ontario},
abstractNote = {Purpose: To quantify differences in treatment delivery efficiency and dosimetry between step-and-shoot intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT) for prostate treatment. Methods and Materials: Twenty-five prostate cancer patients were selected retrospectively for this planning study. Treatment plans were generated for: prostate alone (n = 5), prostate + seminal vesicles (n = 5), prostate + seminal vesicles + pelvic lymph nodes (n = 5), prostate bed (n = 5), and prostate bed + pelvic lymph nodes (n = 5). Target coverage, dose homogeneity, integral dose, monitor units (MU), and sparing of organs at risk (OAR) were compared across techniques. Time required to deliver each plan was measured. Results: The dosimetric quality of IMRT, VMAT, and HT plans were comparable for target coverage (planning target volume V95%, clinical target volume V100% all >98.7%) and sparing of organs at risk (OAR) for all treatment groups. Although HT resulted in a slightly higher integral dose and mean doses to the OAR, it yielded a lower maximum dose to all OAR examined. VMAT resulted in reductions in treatment times over IMRT (mean = 75%) and HT (mean = 70%). VMAT required 15-38% fewer monitor units than IMRT over all treatment volumes, with the reduction per fraction ranging from 100-423 MU from the smallest to largest volumes. Conclusions: VMAT improves efficiency of delivery for equivalent dosimetric quality as IMRT and HT across various prostate cancer treatment volumes in the intact and postoperative settings.},
doi = {10.1016/j.ijrobp.2010.10.024},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 80,
place = {United States},
year = {2011},
month = {8}
}