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Quasi-VMAT in high-grade glioma radiation therapy

Abstract

Purpose: To compare a quasi-volumetric modulated arc therapy (qVMAT) with three-dimensional conformal radiation therapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) for the treatment of high-grade gliomas. The qVMAT technique is a fast method of radiation therapy in which multiple equispaced beams analogous to those in rotation therapy are radiated in succession. Patients and methods: This study included 12 patients with a planning target volume (PTV) that overlapped at least one organ at risk (OAR). 3D-CRT was planned using 2-3 non-coplanar beams, whereby the field-in-field technique (FIF) was used to divide each field into 1-3 subfields to shield the OAR. The qVMAT strategy was planned with 15 equispaced beams and IMRT was planned using 9 beams with a total of 80 segments. Inverse planning for qVMAT and IMRT was performed by direct machine parameter optimization (DMPO) to deliver a homogenous dose distribution of 60 Gy within the PTV and simultaneously limit the dose received by the OARs to the recommended values. Finally, the effect of introducing a maximum dose objective (max. dose < 54 Gy) for a virtual OAR in the form of a 0.5 cm ring around the PTV was investigated. Results: The qVMAT method gave rise to significantly improved  More>>
Authors:
Fadda, G.; Massazza, G.; Zucca, S.; Durzu, S.; Meleddu, G.; Possanzini, M.; Farace, P. [1] 
  1. Regional Oncological Hospital, Cagliari (Italy). Dept. of Radio-Oncology
Publication Date:
May 15, 2013
Product Type:
Journal Article
Resource Relation:
Journal Name: Strahlentherapie und Onkologie; Journal Volume: 189; Journal Issue: 5
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL ADAPTATION; BRAIN; CHEMOTHERAPY; CLINICAL TRIALS; COMBINED THERAPY; CRITICAL ORGANS; EXTERNAL IRRADIATION; GLIOMAS; LINEAR ACCELERATORS; MODULATION; PHOTON BEAMS; PLANNING; RADIATION DOSES; RADIOTHERAPY; TOLERANCE
OSTI ID:
22124781
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0179-7158; CODEN: STONE4; TRN: DE13F7876
Submitting Site:
DEN
Size:
page(s) 367-371
Announcement Date:
Sep 05, 2013

Citation Formats

Fadda, G., Massazza, G., Zucca, S., Durzu, S., Meleddu, G., Possanzini, M., and Farace, P. Quasi-VMAT in high-grade glioma radiation therapy. Germany: N. p., 2013. Web. doi:10.1007/s00066-012-0296-8.
Fadda, G., Massazza, G., Zucca, S., Durzu, S., Meleddu, G., Possanzini, M., & Farace, P. Quasi-VMAT in high-grade glioma radiation therapy. Germany. doi:10.1007/s00066-012-0296-8.
Fadda, G., Massazza, G., Zucca, S., Durzu, S., Meleddu, G., Possanzini, M., and Farace, P. 2013. "Quasi-VMAT in high-grade glioma radiation therapy." Germany. doi:10.1007/s00066-012-0296-8. https://www.osti.gov/servlets/purl/10.1007/s00066-012-0296-8.
@misc{etde_22124781,
title = {Quasi-VMAT in high-grade glioma radiation therapy}
author = {Fadda, G., Massazza, G., Zucca, S., Durzu, S., Meleddu, G., Possanzini, M., and Farace, P.}
abstractNote = {Purpose: To compare a quasi-volumetric modulated arc therapy (qVMAT) with three-dimensional conformal radiation therapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) for the treatment of high-grade gliomas. The qVMAT technique is a fast method of radiation therapy in which multiple equispaced beams analogous to those in rotation therapy are radiated in succession. Patients and methods: This study included 12 patients with a planning target volume (PTV) that overlapped at least one organ at risk (OAR). 3D-CRT was planned using 2-3 non-coplanar beams, whereby the field-in-field technique (FIF) was used to divide each field into 1-3 subfields to shield the OAR. The qVMAT strategy was planned with 15 equispaced beams and IMRT was planned using 9 beams with a total of 80 segments. Inverse planning for qVMAT and IMRT was performed by direct machine parameter optimization (DMPO) to deliver a homogenous dose distribution of 60 Gy within the PTV and simultaneously limit the dose received by the OARs to the recommended values. Finally, the effect of introducing a maximum dose objective (max. dose < 54 Gy) for a virtual OAR in the form of a 0.5 cm ring around the PTV was investigated. Results: The qVMAT method gave rise to significantly improved PTV{sub 95%} and conformity index (CI) values in comparison to 3D-CRT (PTV{sub 95%} = 90.7 % vs. 82.0 %; CI = 0.79 vs. 0.74, respectively). A further improvement was achieved by IMRT (PTV{sub 95%} = 94.4 %, CI = 0.78). In qVMAT and IMRT, the addition of a 0.5 cm ring around the PTV produced a significant increase in CI (0.87 and 0.88, respectively), but dosage homogeneity within the PTV was considerably reduced (PTV{sub 95%} = 88.5 % and 92.3 %, respectively). The time required for qVMAT dose delivery was similar to that required using 3D-CRT. Conclusion: These findings suggest that qVMAT should be preferred to 3D-CRT for the treatment of high-grade gliomas. The qVMAT method could be applied in hospitals, for example, which have limited departmental resources and are not equipped with systems capable of VMAT delivery. (orig.)}
doi = {10.1007/s00066-012-0296-8}
journal = {Strahlentherapie und Onkologie}
issue = {5}
volume = {189}
journal type = {AC}
place = {Germany}
year = {2013}
month = {May}
}