Assessment of the quality of very high-energy electron radiotherapy planning

Palma, Bianey; Bazalova‐Carter, Magdalena; Hårdemark, Björn; Hynning, Elin; Qu, B; Loo, Billy W.; Maxim, Peter G.

doi:10.1016/j.radonc.2016.01.017

Cited by 40 publications

(41 citation statements)

References 10 publications

(20 reference statements)

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“…This effect seems to be accomplished through a relatively small number of beams (i.e., ~9) . The number of beams and beamlet size has also previously been investigated by our group . It was found that any increase of number of beams from the 16 beams used here and reduction in beamlet size lower than 3 mm only marginally increased the VHEE plan performance, and the use of 16 beams with 3 mm beamlet size was found to be optimal when also considering future machine layouts.…”

Section: Discussionmentioning

confidence: 56%

“…The generation of the VHEE beams has been described elsewhere . Briefly, the VHEE pencil beams were calculated in the Monte Carlo EGSnrc/DOSXYZnrc code for 100 and 200 MeV beams through an in‐house developed graphical user interface in Matlab (The Mathworks, Nattick, MA, USA), which has been previously described .…”

Section: Methodsmentioning

confidence: 99%

“…Previous treatment planning studies with VHEE have shown reduced risk organ doses as compared to VMAT plans for a number of different sites . However, no studies to date have shown a robust comparison between VHEE, VMAT, and PPBS in real clinical cases.…”

Section: Introductionmentioning

confidence: 99%

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Very high‐energy electron ( VHEE ) beams in radiation therapy; Treatment plan comparison between VHEE , VMAT , and PPBS

et al. 2017

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The automated optimization developed in this study generated similar or superior plans as compared to the clinically used plan and represents an unbiased approach to compare treatment plans generated for different modalities. In the present study, we also show that VHEE plans are similar or superior to VMAT plans with reduced mean OAR dose and increased target conformity for a variety of clinical cases, and VHEE plans can even achieve reductions in OAR doses compared to PPBS plans for shallow targets. With increased VHEE energy, better conformity and even higher reductions in mean OAR doses are achieved. On the whole, VHEE was intermediate between photon VMAT and PPBS for OAR sparing.

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Section: Discussionmentioning

confidence: 56%

Section: Methodsmentioning

confidence: 99%

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Very high‐energy electron ( VHEE ) beams in radiation therapy; Treatment plan comparison between VHEE , VMAT , and PPBS

et al. 2017

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“…Palma et al . [ 17 ] reported that the most favorable equivalent uniform doses and lowest doses to organs at risk were achieved with variable dose rate VMAT, which was statistically significantly better than 5-field, step-and-shoot IMRT for rectal and femoral head dosimetric endpoints and better than constant dose-rate VMAT for most bladder and rectal endpoints.…”

Section: Discussionmentioning

confidence: 99%

A Dosimetric Comparison between Conventional Fractionated and Hypofractionated Image-guided Radiation Therapies for Localized Prostate Cancer

Hou

et al. 2016

Chinese Medical Journal

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Background:Image-guided radiation therapy (IGRT) is the preferred method for curative treatment of localized prostate cancer, which could improve disease outcome and reduce normal tissue toxicity reaction. IGRT using cone-beam computed tomography (CBCT) in combination with volumetric-modulated arc therapy (VMAT) potentially allows smaller treatment margins and dose escalation to the prostate. The aim of this study was to compare the difference of dosimetric diffusion in conventional IGRT using 7-field, step-and-shoot intensity-modulated radiation therapy (IMRT) and hypofractionated IGRT using VMAT for patients with localized prostate cancer.Methods:We studied 24 patients who received 78 Gy in 39 daily fractions or 70 Gy in 28 daily fractions to their prostate with/without the seminal vesicles using IMRT (n = 12) or VMAT (n = 12) for prostate cancer between November 2013 and October 2015. Image guidance was performed using kilovoltage CBCT scans equipped on the linear accelerator. Offline planning was performed using the daily treatment images registered with simulation computed tomography (CT) images. A total of 212 IMRT plans in conventional cohort and 292 VMAT plans in hypofractionated cohort were enrolled in the study. Dose distributions were recalculated on CBCT images registered with the planning CT scanner.Results:Compared with 7-field, step-and-shoot IMRT, VMAT plans resulted in improved planning target volume (PTV) D95% (7663.17 ± 69.57 cGy vs. 7789.17 ± 131.76 cGy, P < 0.001). VMAT reduced the rectal D25 (P < 0.001), D35 (P < 0.001), and D50 (P < 0.001), bladder V50 (P < 0.001), D25 (P = 0.002), D35 (P = 0.028), and D50 (P = 0.029). However, VMAT did not statistically significantly reduce the rectal V50, compared with 7-field, step-and-shoot IMRT (25.02 ± 5.54% vs. 27.43 ± 8.79%, P = 0.087).Conclusions:To deliver the hypofractionated radiotherapy in prostate cancer, VMAT significantly increased PTV D95% dose and decreased the dose of radiation delivered to adjacent normal tissues comparing to 7-field, step-and-shoot IMRT. Daily online image-guidance and better management of bladder and rectum could make a more precise treatment delivery.

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“…15,23 The present research on VHEEs aims to investigate technical features, treatment quality, delivery and manipulation of VHEEs. [24][25][26][27] To improve dose distribution and examine the radiobiological effectiveness (RBE) of VHEEs have yet to be explored. Figure 1 presents Monte Carlo calculated percentage depth dose (PDD) curves in 30 × 30 × 30 cm 3 water phantom for various types of radiation with 10 × 10 cm 2 field size.…”

Section: Introductionmentioning

confidence: 99%

Laser-plasma generated very high energy electrons (VHEEs) in radiotherapy

et al. 2017

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As an alternative modality to conventional radiotherapy, electrons with energies above 50 MeV penetrate deeply into tissue, where the dose can be absorbed within a tumour volume with a relatively small penumbra. We investigate the physical properties of VHEEs and review the state-of-the-art in treatment planning and dosimetry. We discuss the advantages of using a laser wakefield accelerator (LWFA) and present the characteristic features of the electron bunch produced by the LWFA and compare them with that from a conventional linear accelerator.

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Assessment of the quality of very high-energy electron radiotherapy planning

Abstract: The dosimetric advantages of VHEE as demonstrated for a variety of clinical cases, combined with the theoretical ultra fast treatment delivery, afford VHEE scanning pencil beam radiotherapy a suitable and potentially superior alternative for cancer radiotherapy.

Cited by 40 publications

References 10 publications

Very high‐energy electron ( VHEE ) beams in radiation therapy; Treatment plan comparison between VHEE , VMAT , and PPBS

Very high‐energy electron ( VHEE ) beams in radiation therapy; Treatment plan comparison between VHEE , VMAT , and PPBS

A Dosimetric Comparison between Conventional Fractionated and Hypofractionated Image-guided Radiation Therapies for Localized Prostate Cancer

Laser-plasma generated very high energy electrons (VHEEs) in radiotherapy

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