title: Target splitting non-coplanar RapidArc radiation therapy for a diffuse sebaceous carcinoma of the scalp: a novel delivery technique.
abstract: OBJECTIVE
  To compare conventional lateral photon-electron, fixed-beam intensity modulated radiation therapy (IMRT), coplanar and non-coplanar RapidArc for the treatment of a diffuse sebaceous gland carcinoma of the scalp.
  
  
  METHODS
  Comprehensive dosimetry comparisons were performed among 3D-CRT, IMRT and various RapidArc plans. Target coverage, conformity index (CI), homogeneity index (HI) and doses to organs at risk (OAR) were calculated. Monitor unites (MUs) and delivery time of each treatment were also recorded to evaluate the execution efficiency. The influence of target splitting technique and non-coplanar planning on plan quality was discussed.
  
  
  RESULTS
  IMRT was superior to 3D-CRT concerning targets' coverage at the sacrifice of larger irradiated brain volumes to low doses. CIs and HIs were better in coplanar RapidArc and non-coplanar RapidArc plans than 3D-CRT and IMRT. Best dose coverage and sparing of OARs were achieved in non-coplanar plans using target splitting technique. Treatment delivery time was longest in the IMRT plan and shortest in the coplanar RapidArc plan without target splitting. The 3%/3 mm gamma test pass rates were above 95% for all the plans.
  
  
  CONCLUSIONS
  Target splitting technique and non-coplanar arcs are recommended for total scalp irradiation.
authors.forename: Jiang
authors.initials: J
authors.lastname: Hu
authors.forename: WeiWei
authors.initials: W
authors.lastname: Xiao
authors.forename: ZhiChun
authors.initials: Z
authors.lastname: He
authors.forename: DeHua
authors.initials: D
authors.lastname: Kang
authors.forename: Along
authors.initials: A
authors.lastname: Chen
authors.affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China. qizhy@sysucc.org.cn.
authors.forename: ZhenYu
authors.initials: Z
authors.lastname: Qi
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000532:radiotherapy*; D004583:Electrons / Q000627:therapeutic use*; D005240:Feasibility Studies; D006801:Humans; D017785:Photons / Q000627:therapeutic use*; D011874:Radiometry; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012535:Scalp / Q000473:pathology; D012626:Sebaceous Gland Neoplasms / Q000532:radiotherapy*