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Title: A review of stereotactic body radiotherapy – is volumetric modulated arc therapy the answer?

Stereotactic body radiotherapy (SBRT) is a high precision radiotherapy technique used for the treatment of small to moderate extra-cranial tumours. Early studies utilising SBRT have shown favourable outcomes. However, major disadvantages of static field SBRT include long treatment times and toxicity complications. Volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) may potentially mitigate these disadvantages. This review aims to assess the feasibility of emerging VMAT and IMRT-based SBRT treatment techniques and qualify which offers the best outcome for patients, whilst identifying any emerging and advantageous SBRT planning trends. A review and synthesis of data from current literature up to September 2013 was conducted on EMBASE, Medline, PubMed, Science Direct, Proquest central, Google Scholar and the Cochrane Database of Systematic reviews. Only full text papers comparing VMAT and or IMRT and or Static SBRT were included. Ten papers were identified that evaluated the results of VMAT/IMRT SBRT. Five related to medically inoperable stage 1 and 2 non-small-cell lung cancer (NSCLC), three to spinal metastasis, one related to abdominal lymph node malignancies, with the final one looking at pancreatic adenocarcinoma. Overall treatment times with VMAT were reduced by 66–70% for lung, 46–58% for spine, 42% and 21% for lymph nodemore » and pancreatic metastasis respectively, planning constraints were met with several studies showing improved organs at risk sparing with IMRT/VMAT to static SBRT. Both IMRT and VMAT were able to meet all planning constraints in the studies reviewed, with VMAT offering the greatest treatment efficiency. Early clinical outcomes with VMAT and IMRT SBRT have demonstrated excellent local control and favourable survival outcomes.« less
Authors:
; ;  [1]
  1. Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, School of Biomedical Sciences, Monash University, Clayton, Vic. (Australia)
Publication Date:
OSTI Identifier:
22402375
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Medical Radiation Sciences (Print); Journal Volume: 62; Journal Issue: 2; Other Information: PMCID: PMC4462986; PMID: 26229679; OAI: oai:pubmedcentral.nih.gov:4462986; Copyright (c) 2015 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology.; This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; CARCINOMAS; EFFICIENCY; HAZARDS; LUNGS; LYMPH NODES; PATIENTS; PLANNING; RADIOTHERAPY; REVIEWS; SYNTHESIS; TOXICITY; VERTEBRAE