Comparison of prostate IMRT and VMAT biologically optimised treatment plans.
Recently, a new radiotherapy delivery technique has become clinically available--volumetric modulated arc therapy (VMAT). VMAT is the delivery of IMRT while the gantry is in motion using dynamic leaf motion. The perceived benefit of VMAT over IMRT is a reduction in delivery time. In this study, VMAT was compared directly with IMRT for a series of prostate cases. For 10 patients, a biologically optimized seven-field IMRT plan was compared with a biologically optimized VMAT plan using the same planning objectives. The Pinnacle RTPS was used. The resultant target and organ-at-risk dose-volume histograms (DVHs) were compared. The normal tissue complication probability (NTCP) for the IMRT and VMAT plans was calculated for 3 model parameter sets. The delivery efficiency and time for the IMRT and VMAT plans was compared. The VMAT plans resulted in a statistically significant reduction in the rectal V25Gy parameter of 8.2% on average over the IMRT plans. For one of the NTCP parameter sets, the VMAT plans had a statistically significant lower rectal NTCP. These reductions in rectal dose were achieved using 18.6% fewer monitor units and a delivery time reduction of up to 69%. VMAT plans resulted in reductions in rectal doses for all 10 patients in the study. This was achieved with significant reductions in delivery time and monitor units. Given the target coverage was equivalent, the VMAT plans were superior.
Hardcastle
Nicholas
N
Centre for Medical Radiation Physics, University of Wollongong, NSW, Australia. hardcastle@humonc.wisc.edu
Tomé
Wolfgang A
WA
Foo
Kerwyn
K
Miller
Andrew
A
Carolan
Martin
M
Metcalfe
Peter
P
D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated
Radiother Oncol. 2004 Oct;73(1):21-32
15465142
Jpn J Clin Oncol. 2006 Apr;36(4):224-30
16537689
Int J Radiat Oncol Biol Phys. 2002 Aug 1;53(5):1097-105
12128107
Med Phys. 2008 Jan;35(1):310-7
18293586
Phys Med Biol. 1995 Sep;40(9):1435-49
8532757
Int J Radiat Oncol Biol Phys. 2010 Apr;76(5):1456-62
19540062
J Urol. 2001 Sep;166(3):876-81
11490237
Med Phys. 1993 Mar-Apr;20(2 Pt 1):311-8
8497215
Int J Radiat Oncol Biol Phys. 2002 Jul 15;53(4):904-12
12095556
J Appl Clin Med Phys. 2010 Jan 28;11(1):3169
20160702
Int J Radiat Oncol Biol Phys. 2004 Dec 1;60(5):1589-601
15590191
Int J Radiat Oncol Biol Phys. 2007 Mar 15;67(4):1066-73
17258870
Phys Med Biol. 2009 Jan 7;54(1):N9-20
19075362
Radiother Oncol. 2009 Nov;93(2):226-33
19765846
Med Phys. 2009 Jun;36(6):2328-39
19610322
Phys Med Biol. 2009 Apr 21;54(8):L37-41; author reply L43-4
19305039
Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):996-1001
18455326
Lancet Oncol. 2008 Apr;9(4):367-75
18374290
Radiat Res Suppl. 1985;8:S13-9
3867079
Strahlenther Onkol. 2006 Sep;182(9):543-9
16944377
Int J Radiat Oncol Biol Phys. 2009 Mar 15;73(4):1286; author reply 1287
19251105
Phys Med Biol. 2009 Apr 21;54(8):L31-4; author reply L35-6
19305042
Med Phys. 2003 May;30(5):979-85
12773007
Int J Radiat Oncol Biol Phys. 1989 Jun;16(6):1623-30
2722599
Acta Oncol. 2009;48(2):227-32
18855157
Cancer J. 2002 Jan-Feb;8(1):62-6
11895204
Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):67-74
17765406
Radiother Oncol. 2000 Jun;55(3):241-9
10869739