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Title: A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer

Abstract

The primary objective of this study was to compare dosimetric variables as well as treatment times of multiple static fields (MSFs), conformal arcs (CAs), and volumetric modulated arc therapy (VMAT) techniques for the treatment of early stage lung cancer using stereotactic body radiotherapy (SBRT). Treatments of 23 patients previously treated with MSF of 48 Gy to 95% of the planning target volume (PTV) in 4 fractions were replanned using CA and VMAT techniques. Dosimetric parameters of the Radiation Therapy Oncology Group (RTOG) 0915 trial were evaluated, along with the van't Riet conformation number (CN), monitor units (MUs), and actual and calculated treatment times. Paired t-tests for noninferiority were used to compare the 3 techniques. CA had significant dosimetric improvements over MSF for the ratio of the prescription isodose volume to PTV (R{sub 100%}, p < 0.0001), the maximum dose 2 cm away from the PTV (D{sub 2} {sub cm}, p = 0.005), and van't Riet CN (p < 0.0001). CA was not statistically inferior to MSF for the 50% prescription isodose volume to PTV (R{sub 50%}, p = 0.05). VMAT was significantly better than CA for R{sub 100%} (p < 0.0001), R{sub 50%} (p < 0.0001), D{sub 2} {sub cm}more » (p = 0.006), and CN (p < 0.0001). CA plans had significantly shorter treatment times than those of VMAT (p < 0.0001). Both CA and VMAT planning showed significant dosimetric improvements and shorter treatment times over those of MSF. VMAT showed the most favorable dosimetry of all 3 techniques; however, the dosimetric effect of tumor motion was not evaluated. CA plans were significantly faster to treat, and minimize the interplay of tumor motion and dynamic multileaf collimator (MLC) motion effects. Given these results, CA has become the treatment technique of choice at our facility.« less

Authors:
 [1]; ;  [2];  [3];  [1];  [2];  [2];  [4]
  1. Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta (Canada)
  2. Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada)
  3. Department of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada)
  4. (Canada)
Publication Date:
OSTI Identifier:
22577847
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Dosimetry; Journal Volume: 40; Journal Issue: 4; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
61 RADIATION PROTECTION AND DOSIMETRY; 62 RADIOLOGY AND NUCLEAR MEDICINE; BEAM MONITORS; COLLIMATORS; DOSIMETRY; LUNGS; NEOPLASMS; PATIENTS; PLANNING; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Dickey, Mike, Roa, Wilson, Drodge, Suzanne, Ghosh, Sunita, Murray, Brad, Scrimger, Rufus, Gabos, Zsolt, E-mail: zgabos@ualberta.ca, and Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta. A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer. United States: N. p., 2015. Web. doi:10.1016/J.MEDDOS.2015.04.006.
Dickey, Mike, Roa, Wilson, Drodge, Suzanne, Ghosh, Sunita, Murray, Brad, Scrimger, Rufus, Gabos, Zsolt, E-mail: zgabos@ualberta.ca, & Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta. A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer. United States. doi:10.1016/J.MEDDOS.2015.04.006.
Dickey, Mike, Roa, Wilson, Drodge, Suzanne, Ghosh, Sunita, Murray, Brad, Scrimger, Rufus, Gabos, Zsolt, E-mail: zgabos@ualberta.ca, and Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta. Thu . "A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer". United States. doi:10.1016/J.MEDDOS.2015.04.006.
@article{osti_22577847,
title = {A planning comparison of 3-dimensional conformal multiple static field, conformal arc, and volumetric modulated arc therapy for the delivery of stereotactic body radiotherapy for early stage lung cancer},
author = {Dickey, Mike and Roa, Wilson and Drodge, Suzanne and Ghosh, Sunita and Murray, Brad and Scrimger, Rufus and Gabos, Zsolt, E-mail: zgabos@ualberta.ca and Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta},
abstractNote = {The primary objective of this study was to compare dosimetric variables as well as treatment times of multiple static fields (MSFs), conformal arcs (CAs), and volumetric modulated arc therapy (VMAT) techniques for the treatment of early stage lung cancer using stereotactic body radiotherapy (SBRT). Treatments of 23 patients previously treated with MSF of 48 Gy to 95% of the planning target volume (PTV) in 4 fractions were replanned using CA and VMAT techniques. Dosimetric parameters of the Radiation Therapy Oncology Group (RTOG) 0915 trial were evaluated, along with the van't Riet conformation number (CN), monitor units (MUs), and actual and calculated treatment times. Paired t-tests for noninferiority were used to compare the 3 techniques. CA had significant dosimetric improvements over MSF for the ratio of the prescription isodose volume to PTV (R{sub 100%}, p < 0.0001), the maximum dose 2 cm away from the PTV (D{sub 2} {sub cm}, p = 0.005), and van't Riet CN (p < 0.0001). CA was not statistically inferior to MSF for the 50% prescription isodose volume to PTV (R{sub 50%}, p = 0.05). VMAT was significantly better than CA for R{sub 100%} (p < 0.0001), R{sub 50%} (p < 0.0001), D{sub 2} {sub cm} (p = 0.006), and CN (p < 0.0001). CA plans had significantly shorter treatment times than those of VMAT (p < 0.0001). Both CA and VMAT planning showed significant dosimetric improvements and shorter treatment times over those of MSF. VMAT showed the most favorable dosimetry of all 3 techniques; however, the dosimetric effect of tumor motion was not evaluated. CA plans were significantly faster to treat, and minimize the interplay of tumor motion and dynamic multileaf collimator (MLC) motion effects. Given these results, CA has become the treatment technique of choice at our facility.},
doi = {10.1016/J.MEDDOS.2015.04.006},
journal = {Medical Dosimetry},
number = 4,
volume = 40,
place = {United States},
year = {Thu Jan 01 00:00:00 EST 2015},
month = {Thu Jan 01 00:00:00 EST 2015}
}