title: Volumetric Modulated Arc Therapy for Spine Radiosurgery: Superior Treatment Planning and Delivery Compared to Static Beam Intensity Modulated Radiotherapy.
abstract: OBJECTIVE
  Spine stereotactic radiosurgery (SRS) delivers an accurate and efficient high radiation dose to vertebral metastases in 1-5 fractions. We aimed to compare volumetric modulated arc therapy (VMAT) to static beam intensity modulated radiotherapy (IMRT) for spine SRS.
  
  
  METHODS
  Ten spine lesions of previously treated SRS patients were planned retrospectively using both IMRT and VMAT with a prescribed dose of 16 Gy to 100% of the planning target volume (PTV). The plans were compared for conformity, homogeneity, treatment delivery time, and safety (spinal cord dose).
  
  
  RESULTS
  All evaluated parameters favored the VMAT plan over the IMRT plans. D min in the IMRT was significantly lower than in the VMAT plan (7.65 Gy/10.88 Gy, p < 0.001), the Dice Similarity Coefficient (DSC) was found to be significantly better for the VMAT plans compared to the IMRT plans (0.77/0.58, resp., p  value < 0.01), and an almost 50% reduction in the net treatment time was calculated for the VMAT compared to the IMRT plans (6.73 min/12.96 min, p < 0.001).
  
  
  CONCLUSIONS
  In our report, VMAT provides better conformity, homogeneity, and safety profile. The shorter treatment time is a major advantage and not only provides convenience to the painful patient but also contributes to the precision of this high dose radiation therapy.
authors.affiliation: Radiation Oncology unit, Oncology Institute, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Leor
authors.initials: L
authors.lastname: Zach
authors.affiliation: Radiation Oncology unit, Oncology Institute, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Lev
authors.initials: L
authors.lastname: Tsvang
authors.affiliation: Radiation Oncology unit, Oncology Institute, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Dror
authors.initials: D
authors.lastname: Alezra
authors.affiliation: Sheba Medical Center, Israel.
authors.forename: Maoz
authors.initials: M
authors.lastname: Ben Ayun
authors.affiliation: Stereotactic Radiosurgery Unit, Talpiot Medical Leadership Program, Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel; Spine Surgery Unit, Talpiot Medical Leadership Program, Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.
authors.forename: Ran
authors.identifier: 0000-0002-0165-7114
authors.initials: R
authors.lastname: Harel
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D013125:Spinal Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D013131:Spine / Q000473:pathology / Q000601:surgery*