Static beam tomotherapy as an optimisation method in whole‐breast radiation therapy (WBRT)

Squires, Matthew; Hu, Yunfei; Byrne, Mikel; Archibald-Heeren, Ben; Cheers, Sonja; Bosco, Bruno; Teh, Amy; Fong, Andrew

doi:10.1002/jmrs.232

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…The TomoHelical (TH) mode is one of the delivery modalities used in the TomoTherapy system. It provides a continuous 360‐degrees beam that may result in optimal dose distribution and dose conformity . The TomoTherapy system also allows the delivery of precise image‐guided IMRT (IG‐IMRT) by acquiring a daily megavolt computed tomography (MVCT) scan immediately before treatment …”

Section: Introductionmentioning

confidence: 99%

“…It provides a continuous 360-degrees beam that may result in optimal dose distribution and dose conformity. 4,5 The TomoTherapy system also allows the delivery of precise image-guided IMRT (IG-IMRT) by acquiring a daily megavolt computed tomography (MVCT) scan immediately before treatment. 6 Despite improved target coverage and the advantage of high set up accuracy, a large volume of lung tissue still This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.…”

Section: Introductionmentioning

confidence: 99%

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Treatment outcome for locally advanced non‐small‐cell lung cancer using TomoDirect plan and its characteristics compared to the TomoHelical plan

Mukai

Omura

Hashimoto³

et al. 2018

J of Medical Radiation Sci

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IntroductionTomoDirect (TD) is an intensity‐modulated radiotherapy system that uses a fixed gantry angle instead of the rotational beam delivery used in the TomoHelical (TH) system. This study was performed (1) to evaluate the treatment outcome of the TD plan for locally advanced non‐small‐cell lung cancer (NSCLC) and (2) to compare the characteristics of TD plans with those of TH plans.MethodsTwenty‐one patients with NSCLC were treated using the TD system. The prescribed dose was 40 Gy/20 Fx for the initial planning target volume (PTV), which included the gross tumour volume (GTV) and lymph node regions. A boost plan of 20 Gy/10 Fx was then applied, focusing on the GTV. For the planning study, matched TH plans of 40 Gy for the initial PTV were created for each patient, to meet the same dosimetric constraints specified in the TD plans.ResultsThe 2‐year overall survival, progression‐free survival and local control rates were 47%, 45% and 74% respectively. Grade 2 treatment‐related pneumonitis occurred in three (14%) patients. The planning study comparing TD and TH showed that dose distribution to GTV and PTV were not significantly different. The lung V5 Gy was lower in the TD plans than TH plans (46.4 ± 5.4 vs. 52.3 ± 8.5), while the V20 Gy was higher (26.2 ± 4 vs. 24 ± 4.3). The TD plans had a significantly shorter treatment time than TH plans (4.5 ± 1.3 min vs. 9.8 ± 1.5 min).ConclusionsTD is a clinically acceptable treatment option for NSCSL. The quality of the TD and TH plans are comparable.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment outcome for locally advanced non‐small‐cell lung cancer using TomoDirect plan and its characteristics compared to the TomoHelical plan

Mukai

Omura

Hashimoto³

et al. 2018

J of Medical Radiation Sci

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“…This is more of a problem during initial image acquisition, as during treatment delivery patient motion can be accounted for by adding proper margin or overshoot in planning to account for organ motion. [ 20 ]…”

Section: Discussionsmentioning

confidence: 99%

A feasibility study on the use of tomotherapy megavoltage computed tomography images for palliative patient treatment planning

Byrne²,

Archibald-Heeren³

et al. 2017

J Med Phys

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Dedicated rapid access palliative radiation therapy improves patients’ access to care, allowing more timely treatment which would positively impact on quality of life. The TomoTherapy (Accuray, Sunnyvale, CA) system provides megavoltage (MV) fan-beam computed tomography (FBCT) as the image guidance technique, and a module called “statRT” that allows the use of these MV FBCT images for direct planning. The possibility of using this imaging modality for palliative radiotherapy treatment planning is assessed against accepted planning CT standards by performing tests following AAPM TG 66 and an end-to-end measurement. Results have shown that MV FBCT images acquired by TomoTherapy are of sufficient quality for the purpose of target delineation and dose calculation for palliative treatments. Large image noise and extended scan acquisition time are the two main drawbacks, so this imaging modality should only be used for palliative treatments at areas with well-known, easily distinguishable, and relatively immobile targets such as spine and whole brain.

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“…TomoDirect utilizes static gantry positions combined with simultaneous couch translation and dynamic collimator modulation. This approach avoids the low-dose integral spray to the lung and long treatment times associated with helical methods by confining dose delivery to a few specific angles [ 5 ]. By using such sophisticated conformal irradiation techniques, the incidental dose to axillary lymph drainage routes can be further reduced.…”

Section: Introductionmentioning

confidence: 99%

Incidental Axillary Dose of Tomotherapy in Hypofractionated Whole Breast Radiotherapy for Early Breast Cancer: A Dosimetrical Analysis

et al. 2023

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Background and Objectives: Intensity-modulated radiation therapy (IMRT) is becoming a more common method of performing whole breast irradiation (WBI) for early breast cancer. This study aimed to examine the incidental dose to the axillary region using tomotherapy, a unique form of IMRT. Patients and Methods: This study included 30 patients with early-stage breast cancer who underwent adjuvant WBI using TomoDirect IMRT. A hypofractionation scheme of 42.4 Gy delivered in 16 fractions was prescribed. The plan comprised of two parallel-opposed beams, along with two additional beams positioned anteriorly at gantry angles of 20° and 40° from the medial beam. The incidental dose received at axillary levels I, II, and III was evaluated using several dose-volume parameters. Results: The study participants had a median age of 51 years, and 60% had left-sided breast cancer. The mean dose of the axilla for levels I, II, and III were 15.5 ± 4.8 Gy, 14.9 ± 4.2 Gy, and 1.5 ± 1.6 Gy, respectively. Adequate coverage of the axilla, defined as V95%[%], was achieved for 4.7 ± 3.9%, 4.8 ± 3.7%, and 0 ± 0% for levels I, II, and III, respectively. The results were compared with those of previously published studies, and the axillary mean dose and V95%[%] of TomoDirect IMRT were low, comparable to other IMRT techniques, and lower than those of traditional tangential therapy. Conclusions: While incidental axillary radiation during WBI has been proposed to assist in regional disease control, the TomoDirect plan was demonstrated to decrease this dose, and a hypofractionation scheme would further lower its biological effectiveness. Future clinical studies should incorporate dosimetrical analysis of incidental axillary dose, in order to facilitate hypofractionated IMRT planning with risk-adjusted axilla coverage in early breast cancer.

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Static beam tomotherapy as an optimisation method in whole‐breast radiation therapy (WBRT)

Cited by 6 publications

References 23 publications

Treatment outcome for locally advanced non‐small‐cell lung cancer using TomoDirect plan and its characteristics compared to the TomoHelical plan

Treatment outcome for locally advanced non‐small‐cell lung cancer using TomoDirect plan and its characteristics compared to the TomoHelical plan

A feasibility study on the use of tomotherapy megavoltage computed tomography images for palliative patient treatment planning

Incidental Axillary Dose of Tomotherapy in Hypofractionated Whole Breast Radiotherapy for Early Breast Cancer: A Dosimetrical Analysis

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