Total Marrow Irradiation With RapidArc Volumetric Arc Therapy

Journal Article · Sat Oct 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.11.035· OSTI ID:21587725

Aydogan, Bulent ^[1]; Yeginer, Mete ^[2]; Kavak, Gulbin O ^[3]; Fan, John ^[4]; Radosevich, James A ^[2]; Gwe-Ya, Kim ^[5]

---

1. Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States)
2. Center for Molecular Biology of Oral Diseases, University of Illinois at Chicago, Chicago, IL (United States)
3. Department of Radiation Oncology, University of Illinois at Chicago Medical Center, Chicago, IL (United States)
4. Department of Radiation Oncology, Edwards Hospital, Naperville, IL (United States)
5. Department of Radiation Oncology, University of California, San Diego, School of Medicine, La Jolla, CA (United States)

Purpose: To develop a volumetric arc therapy (VMAT)-total marrow irradiation (TMI) technique for patients with hematologic malignancies. Methods and Materials: VMAT planning was performed for 6 patients using RapidArc technology. The planning target volume consisted of all the bones in the body from the head to the mid-femur, excluding the extremities, except for the humerus, plus a 3.0-mm margin. The organs at risk included the lungs, heart, liver, kidneys, bowels, brain, eyes, and oral cavity. The VMAT-TMI technique consisted of three plans: the head and neck, the chest, and the pelvis, each with three 330{sup o} arcs. The plans were prescribed to ensure, at a minimum, 95% planning target volume dose coverage with the prescription dose (percentage of volume receiving dose of {>=}12 Gy was 95%). The treatments were delivered and verified using MapCheck and ion chamber measurements. Results: The VMAT-TMI technique reported in the present study provided comparable dose distributions with respect to the fixed gantry linear accelerator intensity-modulated TMI. RapidArc planning was less subjective and easier, and, most importantly, the delivery was more efficient. RapidArc reduced the treatment delivery time to approximately 18 min from 45 min with the fixed gantry linear accelerator intensity-modulated TMI. When the prescription dose coverage was reduced to 85% from 95% and the mandible and maxillary structures were not included in the planning target volume as reported in a tomotherapy study, a considerable organ at risk dose reduction of 4.2-51% was observed. The average median dose for the lungs and lenses was reduced to 5.6 Gy from 7.2 Gy and 2.4 Gy from 4.5 Gy, respectively. Conclusion: The RapidArc VMAT technique improved the treatment planning, dose conformality, and, most importantly, treatment delivery efficiency. The results from our study suggest that the RapidArc VMAT technology can be expected to facilitate the clinical transition of TMI.

• OSTI ID: 21587725
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 81, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2010.11.035; PII: S0360-3016(10)03655-2; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
CHEST
COMPUTERIZED TOMOGRAPHY
CT-GUIDED RADIOTHERAPY
EYES
FEMUR
HAZARDS
HEART
JAW
KIDNEYS
LIVER
LUNGS
NECK
NEOPLASMS
ORAL CAVITY
PELVIS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
WHOLE-BODY IRRADIATION
BODY
CARDIOVASCULAR SYSTEM
CENTRAL NERVOUS SYSTEM
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
DOSES
EXTERNAL IRRADIATION
FACE
GLANDS
HEAD
IRRADIATION
MEDICINE
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SENSE ORGANS
SKELETON
SKULL
THERAPY
TOMOGRAPHY