A treatment planning and delivery comparison of volumetric modulated arc therapy with or without flattening filter for gliomas, brain metastases, prostate, head/neck and early stage lung cancer

Abstract

It was generally possible to produce FFF-VMAT plans with the same target dose coverage and doses to organs at risk as STD-VMAT plans. Target dose homogeneity tended to be somewhat inferior for FFF-VMAT for the larger targets investigated. For stereotactic radiotherapy, FFF-VMAT resulted in a considerable time gain while maintaining similar plan quality compared to STD beams.

Stereotactic ablative radiation therapy with volumetric modulated arc therapy in flattening filter-free mode for low-, intermediate-, and high-risk prostate cancer patients: Are 2 arcs better than 1?

“…Furthermore, Alongi et al 17 did not include a systematic investigation into the optimal VMAT delivery technique. In this regard, we sought to compare 1-and 2-arc VMAT-FFFM deliveries, a method of delivery not investigated by Gasic et al 18 Ideally, the comparison should consider dosimetry (target volume coverage and doses to the OAR), treatment time, and the degree of the patient's intrafractional motion. Accordingly, the present planning study evaluated dosimetry and treatment time, whereas our upcoming clinical trial will investigate intrafractional motion.…”

“…17,18 Only low-and intermediate-risk patients were considered in these studies. Furthermore, Alongi et al 17 did not include a systematic investigation into the optimal VMAT delivery technique.…”

Dosimetric superiority of flattening filter free beams for single-fraction stereotactic radiosurgery in single brain metastasis

“…With more and more widespread and profound application of linear accelerator in radiotherapy, particularly the appearance of flattening filter free (FFF) beams in recent years, several investigators have studied the role of FFF beams for SRS in brain metastases [13–14]. The use of volumetric modulated arc therapy (VMAT) for SRS with FFF beams has recently been shown to shorten treatment time if compared with traditional flattening filter (FF) beams [15–16].…”

Monte Carlo validation of the TrueBeam 10XFFF phase–space files for applications in lung SABR

“…1 These beam modes offer several advantages for SABR treatments including higher dose rate and smaller out of field scatter. 2,3 Treatment planning studies 4,5 have shown that comparable plan quality can be achieved with FFF beams compared with conventional flat beams, the primary benefit to the patient being significantly reduced beam-on time. However, most commercial treatment planning systems still struggle to provide accurate dosimetry for small field sizes and inhomogeneous media, which are both relevant concerns for SABR lung treatment.…”