Volumetric-modulated arc therapy (VMAT) versus 3D-conformal radiation therapy in supra-diaphragmatic Hodgkin’s Lymphoma with mediastinal involvement: A dosimetric comparison

Higby, C; Khafaga, Yasser; Al-Shabanah, Mohammad; Mousa, Amr; Ilyas, Mohamed Iyoob Mohamed; Nazer, Ghadeer; Khalil, Ehab

doi:10.1016/j.jnci.2016.04.007

Cited by 9 publications

(8 citation statements)

References 20 publications

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“…Multiple studies have mentioned the dosimetric comparison of VMAT with 3D conformal radiation techniques [19][20][21]. When compared to the traditional tangential wedge filters technique, VMAT plans resulted in significantly better tumor coverage and improved homogeneity, but one of the main limitations of the VMAT technique is that a large volume of normal tissues receives low doses [22].…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of Whole Breast Radiotherapy Using Field-in-Field and Volumetric Modulated Arc Therapy Techniques in Left-Sided Breast Cancer Patients

Waheed¹,

Butt²,

Ishtiaq³

et al. 2021

Cureus

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The radiotherapy of left-sided breast cancers is challenging because of neighboring critical organs, posing an increased risk of complications. Various radiation delivery techniques have been used to deliver the desired dose of radiation to the target area while keeping the doses to nearby structures within constraints.The main aim of this study is to quantify doses delivered to the organs at risk (OARs) including heart, left lung, spinal cord, and contralateral breast, and to the planning target volume (PTV) using Field-in-Field (FIF) and Volumetric Modulated Arc Therapy (VMAT). Patients and methodsA retrospective review of 15 left-sided breast cancer patients was done. All the patients underwent breastconserving surgery and adjuvant radiation. For every patient, two different radiation treatment plans were formulated and compared for the PTV coverage and doses to OARs, including heart, ipsilateral lung, spinal cord, and contralateral breast.The radiation treatment techniques utilized for this purpose were FIF and VMAT. The homogeneity index (HI), and conformity index (CI) required for the treatment planning were also calculated. Data was analyzed using Statistical Package for the Social Sciences (IBM Corp., Armonk, USA). An Independent T-test was used for statistical analysis. ResultsThe mean age was 41 years and the majority of them were stage II. Total nine patients were given 4005centi Gray (cGy) in 15 fractions (fr) followed by 10Gy boost, hence receiving a total dose of 5005cGy in 20fr. While remaining six patients were given a total dose 4005cGy in 15fr without any boost.All patients were hypofractionated and the dose was delivered at a rate of 267cGy per fr. The FIF technique utilized in breast cancer radiation significantly reduced the mean doses to OARs: mean heart dose (3.81cGy), ipsilateral lung dose (V16-15cGy), mean contralateral breast dose (0.03cGy), and maximum spinal cord dose (0.18cGy); as compared to VMAT technique which delivered comparatively higher doses: mean heart dose (8.85cGy), ipsilateral lung dose (V16-19.82cGy), mean contralateral breast dose (4.59cGy), and maximum spinal cord dose (7.14cGy).There was a significant mean difference between doses of OARs and all p-values were statistically significant (p<0.005). Moreover, the FIF technique also improves the dose distribution of PTV in terms of dose homogeneity. However, the conformity index is more enhanced with VMAT as opposed to FIF. ConclusionThe FIF technique is more advantageous than the VMAT planning technique because it provides better dose distribution in terms of PTV coverage and significantly lower doses to OARs in radiotherapy to left-sided breast cancer.

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Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of Whole Breast Radiotherapy Using Field-in-Field and Volumetric Modulated Arc Therapy Techniques in Left-Sided Breast Cancer Patients

Waheed¹,

Butt²,

Ishtiaq³

et al. 2021

Cureus

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“…The VMAT method shared similar characteristics but employed more beams from all angles around the patients and reduced the treatment time . Because of this, they were expected to deliver higher integral dose to normal tissues . The VMAT3 had the potential to produce more conformal dose distribution than VMAT2 but required one additional gantry rotation and therefore increased the treatment time.…”

Section: Discussionmentioning

confidence: 99%

A dosimetric comparison of the use of equally spaced beam (ESB), beam angle optimization (BAO), and volumetric modulated arc therapy (VMAT) in head and neck cancers treated by intensity modulated radiotherapy

Leung

Liu³

et al. 2019

J Applied Clin Med Phys

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IntroductionPrevious studies have shown that the beam arrangement had significant influence on plan quality in intensity modulated radiotherapy (IMRT). This study aimed to evaluate the dosimetric performance of beam arrangement methods by employing equally spaced beams (ESB), beam angle optimization (BAO), and volumetric modulated arc therapy (VMAT) in the planning of five types of head and neck (H&N) cancers treated by IMRT.MethodsFive plans of different beam arrangement methods were optimized for 119 H&N cancer patients with the prescription of 66–70 Gy for high‐risk planning target volume (PTV), 60 Gy for intermediate risk PTV, 54 Gy for low‐risk PTV using a simultaneously integrated boost method. The five‐beam arrangement methods were: ESB, coplanar BAO (BAOc), noncoplanar BAO (BAOnc), two‐arc VMAT (VMAT2), and three‐arc VMAT (VMAT3). The H&N cancers included cancers of nasopharynx, oral cavity, larynx, maxillary sinus, and parotid. Although the partial arc VMAT could be used in cases where the PTVs were situated at one side of the head such as the parotid, this arrangement was not included because it was intended to include only the beam arrangements that were applicable to all the types of head and neck cancers in the study. The plans were evaluated using a “figure‐of‐merit” known as uncomplicated target conformity index (UTCI). In addition, PTV conformation number and homogeneity index, normal tissue integral dose, and organ at risk (OAR) doses were also used. The mean values of these parameters were compared among the five plans.ResultsAll treatment plans met the preset dose requirements for the target volumes and OARs. For nasopharyngeal cancer, VMAT3 and BAOnc demonstrated significantly higher UTCI. For cancer of oral cavity, most beam arrangement showed similar UTCI except ESB, which was relatively lower. For cancer of larynx, there was no significant difference in UTCI among the five‐beam arrangement methods. For cancers of maxillary sinus and parotid gland, the two BAO methods showed marginally higher UTCI among all the five methods.ConclusionIndividual methods showed dosimetric advantages on certain aspects, and the UTCI of the BAO treatment plans are marginally greater in the case of maxillary sinus and parotid gland. However, if treatment time was included into consideration, VMAT plans would be recommended for cancers of the nasopharynx, oral cavity, and larynx.

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“…Heart, lungs, breasts, thyroid Table 1 summarizes the main findings of these studies, focusing on the dose distribution on the heart, lungs, breasts, and thyroid [7,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Dosimetric Studies Of Imrt Vs 3d-crtmentioning

confidence: 99%

“…IMRT usually increased the so-called "low-dose bath" to the rest of the body when compared to the anteroposterior/postero-anterior (AP-PA) approach and 3D-CRT [20,22,38]. However, a few techniques, including non-coplanar IMRT [31], allowed for a reduction of the mean integral dose.…”

Section: Integral Dosementioning

confidence: 99%

“…Chera et al [22] reported a significant decrease in total body V30 and V24 with IMRT vs. AP-PA. In a comparison of 3D-CRT vs. Helical Tomotherapy (HT), Higby et al [38] identified an increase of body V5 from 23.3 to 32.7%, while V10 was almost equal (20.6% vs. 20.5%, respectively). Hoppe et al [25] reported a 22% increase of body V4 for IMRT compared to 3D-CRT, while V10 was similar, and V20 and V30 were reduced by 41 and 63%, as was the mean dose (7.7 Gy vs. 9.5 Gy, respectively).…”

Section: Integral Dosementioning

confidence: 99%

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Fondazione Italiana Linfomi (FIL) expert consensus on the use of intensity-modulated and image-guided radiotherapy for Hodgkin’s lymphoma involving the mediastinum

et al. 2020

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Aim: Advances in therapy have resulted in improved cure rates and an increasing number of long-term Hodgkin's lymphoma (HL) survivors. However, radiotherapy (RT)-related late effects are still a significant issue, particularly for younger patients with mediastinal disease (secondary cancers, heart diseases). In many Centers, technological evolution has substantially changed RT planning and delivery. This consensus document aims to analyze the current knowledge of Intensity-Modulated Radiation Therapy (IMRT) and Image-Guided Radiation Therapy (IGRT) for mediastinal HL and formulate practical recommendations based on scientific evidence and expert opinions. Methods: A dedicated working group was set up within the Fondazione Italiana Linfomi (FIL) Radiotherapy Committee in May 2018. After a first meeting, the group adopted a dedicated platform to share retrieved articles and other material. Two group coordinators redacted a first document draft, that was further discussed and finalized in two subsequent meetings. Topics of interest were: 1) Published data comparing 3D-conformal radiotherapy (3D-CRT) and IMRT 2) dose objectives for the organs at risk 3) IGRT protocols and motion management.

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Volumetric-modulated arc therapy (VMAT) versus 3D-conformal radiation therapy in supra-diaphragmatic Hodgkin’s Lymphoma with mediastinal involvement: A dosimetric comparison

Cited by 9 publications

References 20 publications

Dosimetric Comparison of Whole Breast Radiotherapy Using Field-in-Field and Volumetric Modulated Arc Therapy Techniques in Left-Sided Breast Cancer Patients

Dosimetric Comparison of Whole Breast Radiotherapy Using Field-in-Field and Volumetric Modulated Arc Therapy Techniques in Left-Sided Breast Cancer Patients

A dosimetric comparison of the use of equally spaced beam (ESB), beam angle optimization (BAO), and volumetric modulated arc therapy (VMAT) in head and neck cancers treated by intensity modulated radiotherapy

Fondazione Italiana Linfomi (FIL) expert consensus on the use of intensity-modulated and image-guided radiotherapy for Hodgkin’s lymphoma involving the mediastinum

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