Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Li, Chengqiang; Chen, Jinhu; Jing-ci, Zhu; Gong, Guanzhong; Cheng, Tao; Li, Zhenjiang; Lü, Jie; Yin, Yong

doi:10.7150/jca.32500

Cited by 28 publications

(36 citation statements)

References 34 publications

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“…Previous studies have demonstrated that Halcyon could reduce the treatment time signi cantly compared to conventional LINACs [3][4][5][6][7]. Our study proved the same results in radiotherapy for bilateral breast cancer.…”

Section: Discussionsupporting

confidence: 83%

“…Halcyon has many differences from conventional C-arm LINACs, such as jawless, dual-layer multi-leaf collimator (MLC), faster gantry rotation and daily image guided radiotherapy (IGRT). Comparable dose distribution and excellent delivery e ciency have been shown on Halcyon in radiotherapy for head and neck, brain, unilateral breast, and cervical cancers [3][4][5][6][7]. Trilogy is a conventional C-arm LINAC with jaw and Millennium MLC.…”

Section: Introductionmentioning

confidence: 99%

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Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer 

Sun

Lin

Zhang

et al. 2020

Preprint

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Background: To evaluate the dosimetry of Halcyon in treatment of bilateral breast cancer with volumetric modulated arc therapy. Methods: On CT images of 10 patients with bilateral breast cancer, four Halcyon plans with different setup fields were generated and dosimetric comparisons were conducted among the four plans to select an optimal setup field mode. The four setup-field plans were referred to as CBCT-H, CBCT-L, MV-H, MV-L. Whole and partial arc plans on Trilogy and Halcyon referred to as T-4arc, T-8arc, H-4arc and H-8arc were designed. The dosimetric differences between whole and partial arc plans in the same accelerator were compared to understand the most suitable field setting mode. The better Halcyon plan was selected to the further dosimetric comparison of the plan quality and delivery efficiency between Trilogy and Halcyon. Results: CBCT-H plans increased Dmean, D2 and V107 of planning target volume (PTV) and V5 and Dmean of the heart, left ventricle (LV) and lungs compared to other plans. No significantly dosimetric differences were observed in PTV and organs at risk (OARs) among CBCT-L, MV-H and MV-L. The mean dose and low dose volume of heart, lungs and liver were significantly decreased in T-8arc plans. In terms of V5, V20, V30, V40 and Dmean of the heart, V20, V30, V40 and Dmean of the LV, V30, V40, Dmax and Dmean of the left anterior descending artery (LAD), V5 and V40 of lungs, H-8arc was significantly higher than H-4arc (p<0.05). Compared to Trilogy’s plans, Halcyon’s plans reduced the high-dose volume of the heart and LV, but increased the mean dose of the heart. For the dose of the LAD and the V20, V30 of lungs, there was no statistical difference between the two accelerators. Compared with Trilogy, plans on Halcyon significantly increased the skin dose, but also significantly reduced the delivery time. Conclusion: For Halcyon, the whole-arc plans has more dosimetric advantages in bilateral breast cancer radiotherapy. Although the mean dose of the heart and the skin dose are increased, the dose of the cardiac substructure and other OARs are comparable to the Trilogy, and the delivery time is significantly reduced.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer 

Sun

Lin

Zhang

et al. 2020

Preprint

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“…The potential of Halcyon for cervix uteri was investigated also by Li [20], over a group of 30 patients with a dose prescription of 50.4Gy and no SIB and with dose-volume aims different from the highly demanding Embrace constraints, i.e. in a substantially different setting from what applied in the present investigation.…”

Section: Discussionmentioning

confidence: 92%

“…After its clinical introduction in 2017, the performance of the new radiotherapy delivery platform Halcyon (H, Varian Medical Systems, Palo Alto, USA) was investigated for a variety of different treatment indications [10][11][12][13][14][15][16][17][18][19][20]. In general, the potential performance equivalence between H and other carm delivery systems was proven for head and neck, breast, prostate [13] and brain tumours [15].…”

Section: Introductionmentioning

confidence: 99%

“…With early versions of the Halcyon environment, Anamalayil [16], Brady [17] and Mihailidis [18] showed that: i) a good agreement was achievable between plans optimised for H or for other conventional platforms for both IMRT and VMAT and that ii) the use of multiple isocenters (with auto-feathering of overlapping fields/arcs) could overcome the field size limitations of H. More recently, using the second generation release of the Halcyon system, Kim [19] reported about the clinical use of enhanced planning capabilities of H for the treatment of long targets using dual-isocenters. Li [20] compared the performance of Halcyon versus a conventional c-arm linac for IMRT.…”

Section: Introductionmentioning

confidence: 99%

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Treatment planning comparison of volumetric modulated arc therapy employing a dual-layer stacked multi-leaf collimator and helical tomotherapy for cervix uteri

et al. 2020

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Purpose: To ascertain the dosimetric performance of a new delivery system (the Halcyon system, H) equipped with dual-layer stacked multi-leaf collimator (MLC) for risk-adapted targets in cervix uteri cancer patients compared to another ring-based system in clinical operation (Helical Tomotherapy, HT). Methods: Twenty patients were retrospectively included in a treatment planning study (10 with positive lymph nodes and 10 without). The dose prescription (45Gy to the primary tumour volume and a simultaneously integrated boost up to 55Gy for the positive patients) and the clinical planning objectives were defined consistently as recommended by an ongoing multicentric clinical trial. Halcyon plans were optimised for the volumetric modulated arc therapy. The plan comparison was performed employing the quantitative analysis of the dose-volume histograms.Results: The coverage of the primary and nodal target volumes was comparable for both techniques and both subsets of patients. The primary planning target volume (PTV) receiving at least 95% of the prescription isodose ranged from 97.2 ± 1.1% (node-negative) to 99.1 ± 1.2% (node-positive) for H and from 96.5 ± 1.9% (node-negative) to 98.3 ± 0.9% (node-positive) for HT. The uncertainty is expressed at one standard deviation from the cohort of patient per each group. For the nodal clinical target volumes, the dose received by 98% of the planning target volume ranged 55.5 ± 0.1 to 56.0 ± 0.8Gy for H and HT, respectively. The only significant and potentially relevant differences were observed for the bowels. In this case, V 40Gy resulted 226.3 ± 35.9 and 186.9 ± 115.9 cm 3 for the node-positive and node-negative patients respectively for Halcyon. The corresponding findings for HT were: 258.9 ± 60.5 and 224.9 ± 102.2 cm 3 . On the contrary, V 15Gy resulted 1279.7 ± 296.5 and 1557.2 ± 359.9 cm 3 for HT and H respectively for node-positive and 1010.8 ± 320.9 versus 1203.8 ± 332.8 cm 3 for node-negative. Conclusion: This retrospective treatment planning study, based on the dose constraints derived from the Embrace II study protocol, suggested the essential equivalence between Halcyon based and Helical Tomotherapy based plans for the intensity-modulated rotational treatment of cervix uteri cancer. Different levels of sparing were observed for the bowels with H better protecting in the high-dose region and HT in the mid-low dose regions. The clinical impact of these differences should be further addressed.

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Comparison of treatment plans for hypofractionated high‐dose prostate cancer radiotherapy using the Varian Halcyon and the Elekta Synergy platforms

Tamihardja

Razinskas

Exner

et al. 2021

J Applied Clin Med Phys

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Purpose To compare radiotherapy plans between an O‐ring and a conventional C‐arm linac for hypofractionated high‐dose prostate radiotherapy in terms of plan quality, dose distribution, and quality assurance in a multi‐vendor environment. Methods Twenty prostate cancer treatment plans were irradiated on the O‐ring Varian Halcyon linac and were re‐optimized for the C‐arm Elekta Synergy Agility linac. Dose‐volume histogram metrics for target coverage and organ at risk dose, quality assurance, and monitor units were retrospectively compared. Patient‐specific quality assurance with ion chamber measurements, gamma index analysis, and portal dosimetry was performed using the Varian Portal Dosimetry system and the ArcCHECK® phantom (Sun Nuclear Corporation). Prostate‐only radiotherapy was delivered with simultaneous integrated boost (SIB) volumetric modulated arc therapy (VMAT) in 20 fractions of 2.5/3.0 Gy each. Results For both linacs, target coverage was excellent and plan quality comparable. Homogeneity in PTVBoost was high for Synergy as well as Halcyon with a mean homogeneity index of 0.07 ± 0.01 and 0.05 ± 0.01, respectively. Mean dose for the organs at risk rectum and bladder differed not significantly between the linacs but were higher for the femoral heads and penile bulb for Halcyon. Quality assurance showed no significant differences in terms of ArcCHECK gamma pass rates. Median pass rate for 3%/2 mm was 99.3% (96.7 to 99.8%) for Synergy and 99.8% (95.6 to 100%) for Halcyon. Agreement between calculated and measured dose was high with a median deviation of −0.6% (−1.7 to 0.8%) for Synergy and 0.2% (−0.6 to 2.3%) for Halcyon. Monitor units were higher for the Halcyon by approximately 20% (p < 0.001). Conclusion Hypofractionated high‐dose prostate cancer SIB VMAT on the Halcyon system is feasible with comparable plan quality in reference to a standard C‐arm Elekta Synergy linac.

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Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Cited by 28 publications

References 34 publications

Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer

Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer

Treatment planning comparison of volumetric modulated arc therapy employing a dual-layer stacked multi-leaf collimator and helical tomotherapy for cervix uteri

Comparison of treatment plans for hypofractionated high‐dose prostate cancer radiotherapy using the Varian Halcyon and the Elekta Synergy platforms

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Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Cited by 28 publications

References 34 publications

Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer&nbsp;

Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer&nbsp;

Treatment planning comparison of volumetric modulated arc therapy employing a dual-layer stacked multi-leaf collimator and helical tomotherapy for cervix uteri

Comparison of treatment plans for hypofractionated high‐dose prostate cancer radiotherapy using the Varian Halcyon and the Elekta Synergy platforms

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Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer

Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer