Comparison between two treatment planning systems for volumetric modulated arc therapy optimization for prostate cancer

Lafond, C.; Gassa, F.; Odin, Christophe; Dréan, Gwenola Le; Even, Justine; Crevoisier, R. de; Pommier, P.; Manens, J.-P.; Biston, Marie-Claude

doi:10.1016/j.ejmp.2012.10.003

Cited by 20 publications

(13 citation statements)

References 19 publications

(20 reference statements)

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“…All plans were generated in Monaco v3.0.0 treatment planning system (TPS) (Elekta Corporation, Atlanta, GA) using Monte Carlo dose calculation algorithm with 6 MV photon beams. The treatment planning in Monaco is a two‐step process that calculates the optimal fluence in the first step and converts it into deliverable MLC segments in the later step (12‐14) . The treatment plan parameters, such as arc length, arc increment, arc start/stop angle, and minimum segment width, were handled based on tumor type and site.…”

Section: Methodsmentioning

confidence: 99%

Analysis of direct clinical consequences of MLC positional errors in volumetric‐modulated arc therapy using 3D dosimetry system

Nithiyanantham

Mani

Subramani

et al. 2015

J Applied Clin Med Phys

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In advanced, intensity‐modulated external radiotherapy facility, the multileaf collimator has a decisive role in the beam modulation by creating multiple segments or dynamically varying field shapes to deliver a uniform dose distribution to the target with maximum sparing of normal tissues. The position of each MLC leaf has become more critical for intensity‐modulated delivery (step‐and‐shoot IMRT, dynamic IMRT, and VMAT) compared to 3D CRT, where it defines only field boundaries. We analyzed the impact of the MLC positional errors on the dose distribution for volumetric‐modulated arc therapy, using a 3D dosimetry system. A total of 15 VMAT cases, five each for brain, head and neck, and prostate cases, were retrospectively selected for the study. All the plans were generated in Monaco 3.0.0v TPS (Elekta Corporation, Atlanta, GA) and delivered using Elekta Synergy linear accelerator. Systematic errors of +1,+0.5,+0.3,0,−1,−0.5,−0.3 mm were introduced in the MLC bank of the linear accelerator and the impact on the dose distribution of VMAT delivery was measured using the COMPASS 3D dosimetry system. All the plans were created using single modulated arcs and the dose calculation was performed using a Monte Carlo algorithm in a grid size of 3 mm. The clinical endpoints D95%,D50%,D2%, and Dmax,D20%, D50% were taken for the evaluation of the target and critical organs doses, respectively. A significant dosimetric effect was found for many cases even with 0.5 mm of MLC positional errors. The average change of dose D95% to PTV for ±1 mm,±0.5 mm, and ±0.3 mm was 5.15%, 2.58%, and 0.96% for brain cases; 7.19%, 3.67%, and 1.56% for head and neck cases; and 8.39%, 4.5%, and 1.86% for prostate cases, respectively. The average deviation of dose Dmax was 5.4%, 2.8%, and 0.83% for brainstem in brain cases; 8.2%, 4.4%, and 1.9% for spinal cord in H&N; and 10.8%, 6.2%, and 2.1% for rectum in prostate cases, respectively. The average changes in dose followed a linear relationship with the amount of MLC positional error, as can be expected. MLC positional errors beyond ±0.3 mm showed a significant influence on the intensity‐modulated dose distributions. It is, therefore, recommended to have a cautious MLC calibration procedure to sufficiently meet the accuracy in dose delivery.PACS number: 87.56

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Section: Methodsmentioning

confidence: 99%

Analysis of direct clinical consequences of MLC positional errors in volumetric‐modulated arc therapy using 3D dosimetry system

Nithiyanantham

Mani

Subramani

et al. 2015

J Applied Clin Med Phys

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“…5 The Monte Carlo algorithm can improve dose calculation accuracy, which has been implemented successfully in clinical settings. Lafond et al 33 recently compared the Monaco TPS and Pinnacle™ TPS (Philips Medical Systems, Madison, WI) for VMAT plans, and found that the bladder wall, femoral heads and healthy tissue doses were significantly lower in Monaco plans. For PTV doses, Monaco plans had higher conformity than Pinnacle plans.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous integrated boost to intraprostatic lesions using different energy levels of intensity-modulated radiotherapy and volumetric-arc therapy

Onal¹,

Sonmez²,

Erbay³

et al. 2014

BJR

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Objective: This study compared the dosimetry of volumetric-arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) with a dynamic multileaf collimator using the Monte Carlo algorithm in the treatment of prostate cancer with and without simultaneous integrated boost (SIB) at different energy levels. Methods: The data of 15 biopsy-proven prostate cancer patients were evaluated. The prescribed dose was 78 Gy to the planning target volume (PTV78) including the prostate and seminal vesicles and 86 Gy (PTV86) in 39 fractions to the intraprostatic lesion, which was delineated by MRI or MR-spectroscopy. Results: PTV dose homogeneity was better for IMRT than VMAT at all energy levels for both PTV78 and PTV86. Lower rectum doses (V 30 -V 50 ) were significantly higher with SIB compared with PTV78 plans in both IMRT and VMAT plans at all energy levels. The bladder doses at high dose level (V 60 -V 80 ) were significantly higher in IMRT plans with SIB at all energy levels compared with PTV78 plans, but no significant difference was observed in VMAT plans. VMAT plans resulted in a significant decrease in the mean monitor units (MUs) for 6, 10, and 15 MV energy levels both in plans with and those without SIB. Conclusion: Dose escalation to intraprostatic lesions with 86 Gy is safe without causing serious increase in organs at risk (OARs) doses. VMAT is advantageous in sparing OARs and requiring less MU than IMRT. Advances in knowledge: VMAT with SIB to intraprostatic lesion is a feasible method in treating prostate cancer. Additionally, no dosimetric advantage of higher energy is observed.Randomized trials have shown a gain in biochemical relapse-free survival using dose escalation for prostate cancer.1 However, isolated local failure is still reported in nearly one-third of patients, even with higher radiotherapy (RT) doses.1 Local recurrence is of clinical importance because a relationship has been suggested between local control, distant metastasis and survival.2 It has also been demonstrated that intraprostatic failure mainly originates at the initial tumour location as a result of intrinsic resistance of a fraction of the tumour clones, which implies that selective dose escalation to the dominant intraprostatic lesion using simultaneous integrated boost (SIB) might be beneficial. With new RT techniques, such as intensity-modulated RT (IMRT) and volumetric-arc therapy (VMAT), SIB could be delivered without increasing acute toxicity.4-7 Several recent studies have performed dosimetric comparison of IMRT and VMAT plans in prostate cancer; 8-10 however, dosimetric evaluation of IMRT and VMAT plans delivering SIB is rare. In these studies, target volume and organs at risk (OARs) doses may vary with different treatment planning systems. Another aspect not often addressed in these planning studies is the photon energy level. 4,8,9,11 Although higher energy photons have the potential advantage of reduced attenuation with depth, this may in turn increase the risk of secondary malignancies because of the presence of neutron...

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“…A wide distribution of low dose to the surrounding normal tissues can be harmful for the patients (18). The differences in DRs for the h-VMAT plan between the two treatment systems have not been compared in vivo 34: 331-337 (2020) In that study, the VMAT treatment plans obtained with Monaco and Pinnacle offered clinically acceptable dose distributions for prostate cancer (10). The DR of the RayStation plan compared to that of the Eclipse plan was wider and had a lower mean in our study.…”

Section: And Coronal (Lower) Dose Distribution Of >5 Gy For the Threementioning

confidence: 99%

“…Multiple commercial treatment planning systems (TPSs) have become available. Lafond et al, (10) have compared the dosimetric parameters of two VMAT treatment planning systems for prostate cancer, whereas Langner et al, (11) have compared point doses between Eclipse and Raystation (Eclipse Version 13.7.29; Varian Medical Systems, Palo Alto, CA, USA and RayStation version 4.7.4.4, RaySearch Medical Laboratories AB, Stockholm, Sweden) for proton therapy. The result of calculation is difficult between TPSs, because the calculation algorithm was different.…”

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confidence: 99%

Oesophageal Cancer: Conformal Radiotherapy vs. Hybrid-VMAT Technique With Two Different Treatment Planning Systems

Miyazaki

Ohira

Ueda

et al. 2019

In Vivo

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Background/Aim: Traditionally, the radiotherapy of oesophageal cancer has been conformal radiotherapy (CRT). We sought to compare dosimetric parameters of conformal radiotherapy (CRT) with those of two treatment planning systems for hybrid-volumetric modulated arc therapy (h-VMAT) for the treatment of oesophageal cancer. Patients and Methods: In 11 patients, we compared: i) planning target volume coverage, ii) dose to organs at risk, and iii) the dose rate (DR) of the three techniques. We evaluated two treatment planning systems: i) Eclipse and ii) RayStation. Results: The Conformity Index of the CRT plan was significantly higher for the h-VMAT plans, compared to all other parameters. Normal lung tissue volumes receiving >5, 13, or 20 Gy were lower with the RayStation plan compared to Eclipse. The volume of cardiac tissue receiving >40 Gy was highest with the CRT plan. The minimum DR in VMAT was lowest for the RayStation plan (49.5 MU/min). Conclusion: The h-VMAT plan using RayStation is the appropriate choice for reducing lung dose.

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Comparison between two treatment planning systems for volumetric modulated arc therapy optimization for prostate cancer

Abstract: For prostate cancer patients, VMAT treatment plans obtained with Monaco and Pinnacle offered clinically acceptable dose distributions. Further investigations are in progress to confirm the performances of the two TPS for irradiating more complex volumes.

Cited by 20 publications

References 19 publications

Analysis of direct clinical consequences of MLC positional errors in volumetric‐modulated arc therapy using 3D dosimetry system

Analysis of direct clinical consequences of MLC positional errors in volumetric‐modulated arc therapy using 3D dosimetry system

Simultaneous integrated boost to intraprostatic lesions using different energy levels of intensity-modulated radiotherapy and volumetric-arc therapy

Oesophageal Cancer: Conformal Radiotherapy vs. Hybrid-VMAT Technique With Two Different Treatment Planning Systems

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