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Title: Total Marrow Irradiation With RapidArc Volumetric Arc Therapy

Abstract

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 prescriptionmore » 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.« less

Authors:
 [1];  [2];  [3];  [4];  [2];  [5];  [3];  [6]
  1. Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL (United States)
  2. (United States)
  3. Center for Molecular Biology of Oral Diseases, University of Illinois at Chicago, Chicago, IL (United States)
  4. Department of Radiation Oncology, University of Illinois at Chicago Medical Center, Chicago, IL (United States)
  5. Department of Radiation Oncology, Edwards Hospital, Naperville, IL (United States)
  6. Department of Radiation Oncology, University of California, San Diego, School of Medicine, La Jolla, CA (United States)
Publication Date:
OSTI Identifier:
21587725
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 81; Journal 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); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
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

Citation Formats

Aydogan, Bulent, E-mail: baydogan@uchicago.edu, Department of Radiation Oncology, University of Illinois at Chicago Medical Center, Chicago, IL, Yeginer, Mete, Kavak, Gulbin O., Center for Molecular Biology of Oral Diseases, University of Illinois at Chicago, Chicago, IL, Fan, John, Radosevich, James A., and Gwe-Ya, Kim. Total Marrow Irradiation With RapidArc Volumetric Arc Therapy. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.11.035.
Aydogan, Bulent, E-mail: baydogan@uchicago.edu, Department of Radiation Oncology, University of Illinois at Chicago Medical Center, Chicago, IL, Yeginer, Mete, Kavak, Gulbin O., Center for Molecular Biology of Oral Diseases, University of Illinois at Chicago, Chicago, IL, Fan, John, Radosevich, James A., & Gwe-Ya, Kim. Total Marrow Irradiation With RapidArc Volumetric Arc Therapy. United States. doi:10.1016/j.ijrobp.2010.11.035.
Aydogan, Bulent, E-mail: baydogan@uchicago.edu, Department of Radiation Oncology, University of Illinois at Chicago Medical Center, Chicago, IL, Yeginer, Mete, Kavak, Gulbin O., Center for Molecular Biology of Oral Diseases, University of Illinois at Chicago, Chicago, IL, Fan, John, Radosevich, James A., and Gwe-Ya, Kim. Sat . "Total Marrow Irradiation With RapidArc Volumetric Arc Therapy". United States. doi:10.1016/j.ijrobp.2010.11.035.
@article{osti_21587725,
title = {Total Marrow Irradiation With RapidArc Volumetric Arc Therapy},
author = {Aydogan, Bulent, E-mail: baydogan@uchicago.edu and Department of Radiation Oncology, University of Illinois at Chicago Medical Center, Chicago, IL and Yeginer, Mete and Kavak, Gulbin O. and Center for Molecular Biology of Oral Diseases, University of Illinois at Chicago, Chicago, IL and Fan, John and Radosevich, James A. and Gwe-Ya, Kim},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2010.11.035},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 81,
place = {United States},
year = {2011},
month = {10}
}