Implementation of a volumetric modulated arc therapy treatment planning solution for kidney and adrenal stereotactic body radiation therapy

Journal Article · Fri Jan 01 04:00:00 EST 2016 · Medical Dosimetry

DOI:https://doi.org/10.1016/J.MEDDOS.2016.09.001· OSTI ID:22685168

Sonier, Marcus ^[1]; Chu, William ^[1]; Lalani, Nafisha; Erler, Darby ^[1]; Cheung, Patrick ^[1]; Korol, Renee ^[1]

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1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Canada)

To develop a volumetric modulated arc therapy (VMAT) treatment planning solution in the treatment of primary renal cell carcinoma and oligometastatic adrenal lesions with stereotactic body radiation therapy. Single-arc VMAT plans (n = 5) were compared with clinically delivered step-and-shoot intensity-modulated radiotherapy (IMRT) with planning target volume coverage normalized between techniques. Target volume conformity, organ-at-risk (OAR) dose, treatment time, and monitor units were compared. A VMAT planning solution, created from a combination of arc settings and optimization constraints, auto-generated treatment plans in a single optimization. The treatment planning solution was evaluated on 15 consecutive patients receiving kidney and adrenal stereotactic body radiation therapy. Treatment time was reduced from 13.0 ± 2.6 to 4.0 ± 0.9 minutes for IMRT and VMAT, respectively. The VMAT planning solution generated treatment plans with increased target homogeneity, improved 95% conformity index, and a reduced maximum point dose to nearby OARs but with increased intermediate dose to distant OARs. The conformity of the 95% isodose improved from 1.32 ± 0.39 to 1.12 ± 0.05 for IMRT and VMAT treatment plans, respectively. Evaluation of the planning solution showed clinically acceptable dose distributions for 13 of 15 cases with tight conformity of the prescription isodose to the planning target volume of 1.07 ± 0.04, delivering minimal dose to OARs. The introduction of a stereotactic body radiation therapy VMAT treatment planning solution improves the efficiency of planning and delivery time, producing treatment plans of comparable or superior quality to IMRT in the case of primary renal cell carcinoma and oligometastatic adrenal lesions.

• OSTI ID: 22685168
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 4 Vol. 41; ISSN 0958-3947
• Country of Publication: United States
• Language: English

Related Subjects

61 RADIATION PROTECTION AND DOSIMETRY
62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMPARATIVE EVALUATIONS
EFFICIENCY
HAZARDS
IMPLEMENTATION
KIDNEYS
LIMITING VALUES
MONITORS
OPTIMIZATION
PATIENTS
PLANNING
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIOTHERAPY