Volumetric modulated arc therapy planning for distal oesophageal malignancies

Hawkins, M.; Bedford, James L.; Warrington, Alan P.; Tait, Diana

doi:10.1259/bjr/25428720

Cited by 26 publications

(15 citation statements)

References 44 publications

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“…Increasing the low dose region may affect pulmonary function and, subsequently, patients' quality of life and survival . Only a few studies on VMAT for esophageal cancer have been published, mostly focused on dosimetric comparison . No other clinical data has been reported on RP in patients with esophageal cancer treated with VMAT.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer

et al. 2015

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BackgroundRadiation pneumonitis (RP) is a common side reaction in radiotherapy for esophageal cancer. There are few reports about RP in esophageal cancer patients receiving postoperative intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). This study aims to analyze clinical or dosimetric factors associated with RP, and provides data for radiotherapy planning.MethodsWe reviewed 68 postoperative esophageal cancer patients who were treated with radiotherapy at the West China Hospital from October 2010 to November 2012 to identify any correlation between the clinical or dosimetric parameters and acute radiation pneumonitis (ARP) or severe acute radiation pneumonitis (SARP) by t-test, chi-square test, and logistic regression analysis.ResultsOf the 68 patients, 33 patients (48.5%) developed ARP, 13 of which (19.1%) developed SARP. Of these 33 patients, 8 (11.8%), 12 (17.6%), 11 (16.2%), and 2 (2.9%) patients were grade 1, 2, 3, and 4 ARP, respectively. Univariate analysis showed that lung infection during radiotherapy, use of VMAT, mean lung dose (MLD), and dosimetric parameters (e.g. V20, V30) are significantly correlated with RP. Multivariate analysis found that lung infection during radiotherapy, MLD ≥ 12 Gy, and V30 ≥ 13% are significantly correlated with an increased risk of RP.ConclusionLung infection during radiotherapy and low radiation dose volume distribution were predictive factors associated with RP and should be accounted for during radiation planning.

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Section: Discussionmentioning

confidence: 99%

Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer

et al. 2015

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“…Benthuysen et al [151] evaluated VMAT in distal oesophageal cancers and found comparable PTV coverage and OAR sparing to fixed field IMRT with a 42-67% reduction in MU, but greater low dose radiation to the body (V5 Gy 18% greater for VMAT plans). Hawkins et al [152] compared VMAT with 4-field CRT in 10 patient datasets with locally advanced or inoperable distal oesophageal cancers. They found improved OAR sparing (V30 Gy to heart 31% vs 55%) and improved PTV conformity with VMAT.…”

Section: Intra-abdominal Tumoursmentioning

confidence: 99%

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

Teoh

Clark²,

Wood³

et al. 2011

BJR

565

440

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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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“…The prescribed dose was 54 Gy in 30 fractions and the technical details of the plans were otherwise as for the lung cases, and following our clinical practice. 36 The three prostate plans were created by copying the PTV, rectum, bladder, bowel, and femoral head volumes from three patients whose prostate and seminal vesicles had previously been treated using the PACE (Prostate Advances in Comparative Evidence) protocol, 37 onto a Solid Water phantom of dimensions 30 cm wide × 30 cm long × 20 cm high. The isocenter was located at the center of the phantom and the three volumes were prescribed to 78 Gy in 39 fractions.…”

Section: C Vmat Dosimetrymentioning

confidence: 99%