Cranio-spinal irradiation with volumetric modulated arc therapy: A multi-institutional treatment experience

Fogliata, Antonella; Bergström, Stefan; Cafaro, Ines; Clivio, Alessandro; Cozzi, Luca; Dipasquale, G.; Hållström, Per; Mancosu, P.; Navarria, Pierina; Nicolini, G.; Parietti, E.; Pesce, G.; Richetti, A.; Scorsetti, Marta; Vanetti, Eugenio; Weber, Damien Charles

doi:10.1016/j.radonc.2011.01.023

Cited by 78 publications

(83 citation statements)

References 37 publications

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“…Difference in Hounsfield Units between the two series is reported, too (e). optimization, a VMAT technique used in different regions both for standard fractionation [14] and for stereotactic body radiation therapy [15].…”

Section: Discussionmentioning

confidence: 99%

Plan robustness in field junction region from arcs with different patient orientation in total marrow irradiation with VMAT

Mancosu¹,

Navarria

Castagna

et al. 2015

Physica Medica

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Section: Discussionmentioning

confidence: 99%

Plan robustness in field junction region from arcs with different patient orientation in total marrow irradiation with VMAT

Mancosu¹,

Navarria

Castagna

et al. 2015

Physica Medica

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“…Two recent studies evaluating VMAT in this setting have been recently published. Fogliata et al [155] reported on their experience using VMAT to deliver CSI in five patients from five different institutions (age range, 7-45 years). They found that VMAT could achieve highly conformal plans with acceptably low doses to OARs.…”

Section: Paediatric Casesmentioning

confidence: 99%

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Teoh

Clark²,

Wood³

et al. 2011

BJR

535

416

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ABSTRACT. Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites.

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“…This inter-center variation in mean doses to the OARs is larger than the differences in OARs doses reported by other published studies comparing irradiation techniques [12,14,35,36]. On the one hand, the large dose range points towards an effect of mastering a technique to a different extent, as already observed for VMAT dose distributions by Fogliata et al [43]. On the other hand, these differences can be attributed to the choice of the optimization criteria made by the centers, prioritizing one objective over another (Table S1).…”

Section: Discussionmentioning

confidence: 49%

Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers: analysis on behalf of the SIOP-E-BTG (radiotherapy working group)

et al. 2018

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Purpose: Conventional techniques (3D-CRT) for craniospinal irradiation (CSI) are still widely used. Modern techniques (IMRT, VMAT, TomoTherapy V R , proton pencil beam scanning [PBS]) are applied in a limited number of centers. For a 14-year-old patient, we aimed to compare dose distributions of five CSI techniques applied across Europe and generated according to the participating institute protocols, therefore representing daily practice. Material and methods: A multicenter (n ¼ 15) dosimetric analysis of five different techniques for CSI (3D-CRT, IMRT, VMAT, TomoTherapy V R , PBS; 3 centers per technique) was performed using the same patient data, set of delineations and dose prescription (36.0/1.8 Gy). Different treatment plans were optimized based on the same planning target volume margin. All participating institutes returned their best treatment plan applicable in clinic. Results: The modern radiotherapy techniques investigated resulted in superior conformity/homogeneity-indices (CI/HI), particularly in the spinal part of the target (CI: 3D-CRT:0.3 vs. modern:0.6; HI: 3D-CRT:0.2 vs. modern:0.1), and demonstrated a decreased dose to the thyroid, heart, esophagus and pancreas. Dose reductions of >10.0 Gy were observed with PBS compared to modern photon techniques for parotid glands, thyroid and pancreas. Following this technique, a wide range in dosimetry among centers using the same technique was observed (e.g., thyroid mean dose: VMAT: 5.6-24.6 Gy; PBS: 0.3-10.1 Gy). Conclusions: The investigated modern radiotherapy techniques demonstrate superior dosimetric results compared to 3D-CRT. The lowest mean dose for organs at risk is obtained with proton therapy. However, for a large number of organs ranges in mean doses were wide and overlapping between techniques making it difficult to recommend one radiotherapy technique over another. ARTICLE HISTORY

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Cranio-spinal irradiation with volumetric modulated arc therapy: A multi-institutional treatment experience

Cited by 78 publications

References 37 publications

Plan robustness in field junction region from arcs with different patient orientation in total marrow irradiation with VMAT

Plan robustness in field junction region from arcs with different patient orientation in total marrow irradiation with VMAT

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers: analysis on behalf of the SIOP-E-BTG (radiotherapy working group)

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