TY - JOUR
T1 - SmartArc-based volumetric modulated arc therapy for oropharyngeal cancer
T2 - A dosimetric comparison with both intensity-modulated radiation therapy and helical tomotherapy
AU - Clemente, Stefania
AU - Wu, Binbin
AU - Sanguineti, Giuseppe
AU - Fusco, Vincenzo
AU - Ricchetti, Francesco
AU - Wong, John
AU - McNutt, Todd
N1 - Funding Information:
Conflict of interest: BB.W. is funded in part by Philips Medical Systems; F.R. is funded in part by Elekta Inc.
PY - 2011/7/15
Y1 - 2011/7/15
N2 - Purpose: To investigate the roles of volumetric modulated arc therapy with SmartArc (VMAT-S), intensity-modulated radiation therapy (IMRT), and helical tomotherapy (HT) for oropharyngeal cancer using a simultaneous integrated boost (SIB) approach. Methods and Materials: Eight patients treated with IMRT were selected at random. Plans were computed for both IMRT and VMAT-S (using Pinnacle TPS for an Elekta Infinity linac) along with HT. A three-dose level prescription was used to deliver 70 Gy, 63 Gy, and 58.1 Gy to regions of macroscopic, microscopic high-risk, and microscopic low-risk disease, respectively. All doses were given in 35 fractions. Comparisons were performed on dose-volume histogram data, monitor units per fraction (MU/fx), and delivery time. Results: VMAT-S target coverage was close to that achieved by IMRT, but inferior to HT. The conformity and homogeneity within the PTV were improved for HT over all strategies. Sparing of the organs at risk (OAR) was achieved with all modalities. VMAT-S (along with HT) shortened delivery time (mean, -38%) and reduced MU/fx (mean, -28%) compared with IMRT. Conclusion: VMAT-S represents an attractive solution because of the shorter delivery time and the lower number of MU/fx compared with IMRT. However, in this complex clinical setting, current VMAT-S does not appear to provide any distinct advantage compared with helical tomotherapy.
AB - Purpose: To investigate the roles of volumetric modulated arc therapy with SmartArc (VMAT-S), intensity-modulated radiation therapy (IMRT), and helical tomotherapy (HT) for oropharyngeal cancer using a simultaneous integrated boost (SIB) approach. Methods and Materials: Eight patients treated with IMRT were selected at random. Plans were computed for both IMRT and VMAT-S (using Pinnacle TPS for an Elekta Infinity linac) along with HT. A three-dose level prescription was used to deliver 70 Gy, 63 Gy, and 58.1 Gy to regions of macroscopic, microscopic high-risk, and microscopic low-risk disease, respectively. All doses were given in 35 fractions. Comparisons were performed on dose-volume histogram data, monitor units per fraction (MU/fx), and delivery time. Results: VMAT-S target coverage was close to that achieved by IMRT, but inferior to HT. The conformity and homogeneity within the PTV were improved for HT over all strategies. Sparing of the organs at risk (OAR) was achieved with all modalities. VMAT-S (along with HT) shortened delivery time (mean, -38%) and reduced MU/fx (mean, -28%) compared with IMRT. Conclusion: VMAT-S represents an attractive solution because of the shorter delivery time and the lower number of MU/fx compared with IMRT. However, in this complex clinical setting, current VMAT-S does not appear to provide any distinct advantage compared with helical tomotherapy.
KW - HT
KW - IMRT
KW - Oropharyngeal cancer
KW - VMAT SmartArc
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U2 - 10.1016/j.ijrobp.2010.08.007
DO - 10.1016/j.ijrobp.2010.08.007
M3 - Article
C2 - 20947268
AN - SCOPUS:79959369960
SN - 0360-3016
VL - 80
SP - 1248
EP - 1255
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -