Can volumetric modulated arc therapy with flattening filter free beams play a role in stereotactic body radiotherapy for liver lesions? A volume-based analysis

Reggiori, G.; Mancosu, P.; Castiglioni, S.; Alongi, Filippo; Pellegrini, Chiara; Lobefalo, F.; Catalano, M.; Fogliata, Antonella; Arcangeli, Stefano; Navarria, Pierina; Cozzi, Luca; Scorsetti, Marta

doi:10.1118/1.3679858

Cited by 54 publications

(63 citation statements)

References 22 publications

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“…Although no modeling details presented, successful modeling of FFF beam in other TPS had also been exemplified. [13] It seems that handling unflattened beams in today's TPS is no longer a problem.…”

Section: Discussionmentioning

confidence: 99%

“…[8] During the past years, feasibility of treating various cancers including prostate, lung, larynx, chest wall, and esophagus using unflattened beams have been reported. [910111213141516] Also exclusive use of a linear accelerator in FFF mode in 3D CRT planning has also been reported to be feasible. [17] From all these published results, a reduced beam on time (BOT) and comparable plan quality seem to have been confirmed for VMAT plan with unflattened beams.…”

Section: Introductionmentioning

confidence: 99%

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A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy in nasopharyngeal carcinoma

Song

et al. 2014

J Med Phys

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Purpose:To explore the dosimetric effects of flattening filter-free (FFF) beams in volumetric modulated arc therapy (VMAT) of nasopharyngeal carcinoma via a retrospective planning study.Materials and Methods:A linear accelerator (LINAC) was prepared to operate in FFF mode and the beam data were collected and used to build a model in TPS. For 10 nasopharyngeal carcinoma (NPC) cases, VMAT plans of FFF beams and normal flattened (FF) beams were designed. Differences of plan quality and delivery efficiency between FFF-VMAT plans and filter filtered VMAT (FF-VMAT) plans were analyzed using two-tailed paired t-tests.Results:Removal of the flattening filter increased the dose rate. Averaged beam on time (BOT) of FFF-VMAT plans was decreased by 24.2%. Differences of target dose coverage between plans with flattened and unflattened beams were statistically insignificant. For dose to normal organs, up to 4.9% decrease in V35 of parotid grand and 4.5% decrease in averaged normal tissue (NT) dose was observed.Conclusions:The TPS used in our study was able to handle FFF beams. The FFF beam prone to improve the normal tissue sparing while achieving similar target dose distribution. Decreasing of BOT in NPC cases was valuable in terms of patient's comfort.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy in nasopharyngeal carcinoma

Song

et al. 2014

J Med Phys

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“…Table III. FFF beams (11). The main advantage was a considerable reduction of beam on time, relevant for SBRT techniques (11). In our study, the treatment delivery efficiency is quantified by lesser BOT.…”

Section: Technology In Cancer Research and Treatment 2014 March 17 Epumentioning

confidence: 99%

“…6X_IMRT and 6F_IMRT reduces the V 10% volumes in the OARs especially in heart (20% reduction), lungs (40% reduction), liver (64.9% reduction), kidneys (62.5% reduction) compared to Rapid Arc therapy as shown in Figure 3. Table III. FFF beams (11). The main advantage was a considerable reduction of beam on time, relevant for SBRT techniques (11).…”

Section: Technology In Cancer Research and Treatment 2014 March 17 Epumentioning

confidence: 99%

Cranio Spinal Irradiation of Medulloblastoma Using High Precision Techniques – A Dosimetric Comparison

Pichandi

Ganesh

Amalraj

et al. 2015

Technol Cancer Res Treat

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“…Since flattening filter is not used in the photon beam, the dose rate can be increased by two to four times of the conventional treatment so that the delivery time can be faster. Reggiori et al (14) have reported considerable reductions in the treatment time, along with some improvement in healthy sparing tissue, by using the high‐dose rate FFF beams in VMAT‐based lung SBRT.…”

Section: Introductionmentioning

confidence: 99%

Is 5 mm MMLC suitable for VMAT‐based lung SBRT? A dosimetric comparison with 2.5 mm HDMLC using RTOG‐0813 treatment planning criteria for both conventional and high‐dose flattening filter‐free photon beams

Subramanian

Subramani

Swamy

et al. 2015

J Applied Clin Med Phys

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The aim of this study is to assess the suitability of 5 mm millennium multileaf collimator (MMLC) for volumetric‐modulated arc therapy (VMAT)‐based lung stereotactic body radiotherapy (SBRT). Thirty lung SBRT patient treatment plans along with their planning target volumes (ranging from 2.01 cc to 150.11 cc) were transferred to an inhomogeneous lung phantom and retrospectively planned using VMAT technique, along with the high definition multileaf collimator (HDMLC) and MMLC systems. The plans were evaluated using Radiation Therapy Oncology Group (RTOG‐0813) treatment planning criteria for target coverage, normal tissue sparing, and treatment efficiency for both the MMLC and HDMLC systems using flat and flattening filter‐free (FFF) photon beams. Irrespective of the target volumes, both the MLC systems were able to satisfy the RTOG‐0813 treatment planning criteria without having any major deviation. Dose conformity was marginally better with HDMLC. The average conformity index (CI) value was found to be 1.069±0.034 and 1.075±0.0380 for HDMLC and MMLC plans, respectively. For the 6 MV FFF beams, the plan was slightly more conformal, with the average CI values of 1.063±0.029 and 1.073±0.033 for the HDMLC and MMLC plans, respectively. The high dose spillage was the maximum for 2 cc volume set (3% for HDMLC and 3.1% for MMLC). In the case of low dose spillage, both the MLCs were within the protocol of no deviation, except for the 2 cc volume set. The results from this study revealed that VMAT‐based lung SBRT using 5 mm MMLC satisfies the RTOG‐0813 treatment planning criteria for the studied target size and shapes.PACS numbers: 87.53.Ly, 87.53D, 87.56.jk

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Can volumetric modulated arc therapy with flattening filter free beams play a role in stereotactic body radiotherapy for liver lesions? A volume-based analysis

Cited by 54 publications

References 22 publications

A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy in nasopharyngeal carcinoma

A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy in nasopharyngeal carcinoma

Cranio Spinal Irradiation of Medulloblastoma Using High Precision Techniques – A Dosimetric Comparison

Is 5 mm MMLC suitable for VMAT‐based lung SBRT? A dosimetric comparison with 2.5 mm HDMLC using RTOG‐0813 treatment planning criteria for both conventional and high‐dose flattening filter‐free photon beams

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