A RapidArc planning strategy for prostate with simultaneous integrated boost

Abstract

Since the clinical implementation of novel rotational forms of intensity‐modulated radiotherapy, a variety of planning studies have been published that reinforce the major selling points of the technique. Namely, comparable or even improved dose distributions with a reduction in both monitor units and treatment times, when compared with static gantry intensity‐modulated radiotherapy. Although the data are promising, a rigorous approach to produce these plans has yet to be established. As a result, this study outlines a robust and streamlined planning strategy with a concentration on RapidArc class solutions for prostate with a simultaneous integrated boost. This planning strategy outlines the field setup, recommended starting objectives, required user interactions to be made throughout optimization and post‐optimization adjustments. A comparative planning study, with static gantry IMRT, is then presented as justification for the planning strategy itself. A variety of parameters are evaluated relating to both the planning itself (optimization and calculation time) and the plans that result. Results of this comparative study are in line with previously published data, and the planning process is streamlined to a point where the RapidArc optimization time takes 15±1.3 minutes. Application of this planning strategy reduces the dependence of the produced plan on the experience of the planner, and has the potential to streamline the planning process within radiotherapy departments.PACS numbers: 87.55.x, 87.55.D, 87.55.de, 87.55.dk

A retrospective planning analysis comparing intensity modulated radiation therapy (IMRT) to volumetric modulated arc therapy (VMAT) using two optimization algorithms for the treatment of early‐stage prostate cancer

“…Volumetric modulated arc therapy planning was demonstrated to produce dose distributions that had a better conformity to the PTV than IMRT. This outcome supports the findings from previous published research . The improved conformity observed using VMAT is a consequence of arc delivery that delivers dose from 360°.…”

“…The dose uniformity across the PTV reported by the HI is significantly better for IMRT than both VMAT techniques. Others have reported a similar trend for homogeneity . The lower homogeneity is reported to be inherent to the optimization algorithm used for VMAT planning …”

“…Dose escalation has been demonstrated to improve local control of prostate cancer . Despite demonstrating improved conformity to the PTV, dose escalation using VMAT may still be limited by planning hotspots that have been reported to be greater for VMAT than IMRT …”

“…There is a growing body of literature supporting that VMAT is capable of delivering treatment to the prostate with a similar or better dose distribution compared to fixed‐field IMRT, yet requires significantly fewer MUs and reduced treatment time than IMRT …”

Dosimetric benefit of DMLC tracking for conventional and sub-volume boosted prostate intensity-modulated arc radiotherapy

“…Treatment planning with increased dose to intraprostatic lesions has previously been studied for different approaches of rotational therapy (Ost et al 2011, Jolly et al 2011). This study added the aspect of planning constraints to make the plans robust for DMLC tracking, as suggested in (Keall et al 2011).…”