Volumetric modulated arc radiotherapy for esophageal cancer

Nagarajan, Vivekanandan; Pothapregada, Sriram; Kumar, S.A. Syam; Bhuvaneswari, N.; Saranya, K.

doi:10.1016/j.meddos.2011.01.008

Cited by 25 publications

(26 citation statements)

References 10 publications

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“…13 In the VMAT technique, dosimetric results similar to the IMRT technique can be obtained using one or more arcs. 14 Many studies have been conducted whether IMRT or VMAT technique is more beneficial for esophagus radiotherapy and comparing several techniques is the topic of discussion.…”

Section: Discussionmentioning

confidence: 99%

Which One is The Better Radiotherapy Technique for Patients with Thoracic Esophageal Tumors, IMRT or VMAT?

Karaoguz¹

2017

UHOD

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Comparison of IMRT and VMAT techniques in thoracic esophageal tumors. IMRT and VMAT plans were created for a total of 10 thorax-located esophagus patients. All plans were compared in terms of HI and CI for PTV; V 5 , V 10 , V 20 and mean lung dose parameters for total lung; V 30 , V 40 and mean heart dose for the heart; and the Dmax for the medulla spinalis. IMRT and VMAT techniques yielded similar results with respect to HI and CI values (p> 0.05). Median mean lung dose was found to be lower in VMAT (11.77 Gy) technique compared to IMRT (12.05 Gy). While the lowest lung median V 5 (67.17%) and V 10 (41.95%) values belonged to IMRT, the V 20 value was achieved with VMAT (17.85%) planning. Median mean heart dose was found the lowest in VMAT (28.81 Gy) and the highest IMRT (29.31 Gy) planning. The lowest heart median V30 value was obtained with IMRT (43.00%) and median V 40 value was obtained with VMAT (18.95%) planning. The median mean medulla spinalis maximum dose was found to be lower with VMAT (41.54 Gy), with no statistically significant difference between them (p= 0.074). VMAT technique was better for reducing cardiovascular and medulla spinalis doses with reduced duration of treatment time and dosimetric uncertainties, while YART technique provides higher PTV control with less low-dose lung volume. Both threatment options have advantages and disadvantages over normal tissue and tumor volume compared to each other, and should be evaluated according to the other clinical conditions of the patient.

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Section: Discussionmentioning

confidence: 99%

Which One is The Better Radiotherapy Technique for Patients with Thoracic Esophageal Tumors, IMRT or VMAT?

Karaoguz¹

2017

UHOD

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“…[7][8][9] Volumetric-modulated arc treatment is also advantageous with shorter treatment times that may decrease the risk of intrafractional positional shifts. [10] In addition to intrafractional chances, interfractional differences may occur due to tumor regression, progression, or displacement. In this context, CBCT is an inevitable component of modern radiotherapy procedures.…”

Section: Discussionmentioning

confidence: 99%

Case Presentation: The Effect of Volumetric Image Guidance & Adaptive Radiotherapy on Cardiac Dose in A Patient with Esophageal Cancer

Sezen¹

2018

TJ Oncol

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SUMMARYWe present the case of a patient with esophageal cancer whose tumor size regression prompted re-planning to decrease the cardiac dose. A 68-year-old male presented at our outpatient clinic with dysphagia. He was diagnosed with clinical T3N1M0 adenocarcinoma located at the distal esophagus-esophagogastric junction. He was decided to have surgery after receiving neoadjuvant chemoradiotherapy. Following 4-D CT simulation, IG-IMRT with SIB technique was planned as 50 Gy in 25 fractions to iGTV and as 45 Gy to the area identified as the CTV. Daily kV and weekly CBCT were planned at the beginning of the treatment. Concurrent CT with weekly paclitaxel-carboplatin was administered. At the simulation and start of the treatment, the heart was pushed anteriorly due to the mass effect and dilatation in the mid-lower esophagus. The mass and dilatation regressed at the weekly CBCT of the patient. The thirdweek CBCT evaluation revealed the movement of the heart posteriorly into the PTV. Re-simulation was performed to continue with the adaptive planning for the last 10 treatment fractions. The cumulative dose received by the heart was reduced from 96% to 93% for V5Gy, from 79% to 60.8% for V10Gy, from 60% to 43.2% for V15Gy, from 35% to 21% for V20Gy, and from 29.6 to 28 Gy for the mean cardiac dose with the volumetric image-guided adaptive planning. If tumor regression is predicted during radiotherapy to possibly change doses of organs at risk, volumetric image guidance should be encouraged once per week, at least, to consider adaptive treatment when required to ensure the critical organ doses within safe limits.

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“…The use of different planning techniques may provide different dosimetric and radiobiological results for AAA and AXB. For example, Vivekanandan et al [9] performed the dosimetric comparison between 3D-conformal radiation therapies, 4-field intensity modulated radiation therapy, and single-arc and double-arc RapidArc plans of esophageal cancer. It would be interesting to investigate if the discrepancies between the results of AAA and AXB calculations would be same for different planning techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the previous dosimetric studies on AXB [3][4][5][6][7][8] were based on physical dose-volume statistics, which can characterize only the certain aspects of the 3D dose distribution. Furthermore, other researchers [9][10][11] have investigated the use of RapidArc technique for esophageal cancer, but the evaluation of Varian's most recent dose calculation algorithm AXB using radiobiological parameters for esophageal cancer remains to be done.…”

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confidence: 99%

Radiobiological evaluation of dose calculation algorithms in RapidArc planning of esophageal cancer treatment plans

Rana

Rogers²

2013

JST

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Purpose: The purpose of current study is to investigate the impact of tissue heterogeneity corrections in Acuros XB algorithm (AXB) and Anisotropic Analytical Algorithm (AAA) on RapidArc esophageal cancer treatment plans using equivalent uniform dose (EUD) calculations and tumor control probability (TCP). Methods:Ten esophageal cancer cases were selected for the current study. All cases were planned using RapidArc technique in Eclipse treatment planning system (10.0.28). The treatment plans were inversely optimized using progressive resolution optimizer and each optimized plan was calculated using AAA with tissue heterogeneity correction. The AAA plans were then normalized such that prescription dose covered 95% of the planning target volume (PTV). The AXB plans were generated by recalculating the normalized AAA plans using AXB with tissue heterogeneity correction for identical monitor units and beam parameters as in the corresponding AAA plans. The EUD and TCP calculations were then performed on the AAA and AXB plans.Results: For PTV, the EUD values in AXB plans were always lower than in AAA plans with an average difference of 1.3%. Similarly, AXB calculations produced smaller magnitude of EUD for the organs at risk (OARs) compared to AAA calculations. On average, in AXB plans, the lung EUD was lower by 3.5%, the liver EUD was lower by 2.3%, the heart EUD was lower by 2.8%, and the spinal cord EUD was lower by 1.8%. The TCP of AXB plans was lower by average difference of 7.1% compared to that of AAA plans. Conclusion:In comparison to AAA calculations, the preliminary results presented in the current study showed that AXB calculations produced lower EUD and TCP for the PTV as well as lower EUD for OARs in the esophageal cancer treatment plans created by RapidArc planning technique.

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Volumetric modulated arc radiotherapy for esophageal cancer

Cited by 25 publications

References 10 publications

Which One is The Better Radiotherapy Technique for Patients with Thoracic Esophageal Tumors, IMRT or VMAT?

Which One is The Better Radiotherapy Technique for Patients with Thoracic Esophageal Tumors, IMRT or VMAT?

Case Presentation: The Effect of Volumetric Image Guidance & Adaptive Radiotherapy on Cardiac Dose in A Patient with Esophageal Cancer

Radiobiological evaluation of dose calculation algorithms in RapidArc planning of esophageal cancer treatment plans

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