title: Can cost make a difference dosimetrically? Volumetric modulated arc therapy study for multileaf collimators of various widths for head and neck and prostate cancers.
abstract: Cancer is a global health issue that disproportionately kills based on stage of disease, cellular pathology, and genetics, to name a few. Another variable to consider in this ongoing fight is treatment machine complexity that leads to elevated development and purchasing cost, leading to a reduced use. Reducing the complexity (in hopes of lowering costs) would benefit underdeveloped, low- and middle-income countries by introducing newer treatment technology, as their currently accepted standards do not meet standards of more advanced, developed countries. In this study, unilateral head and neck (H&N), and prostate cases using volumetric modulated arc therapy (VMAT) were tested with multiple segment widths of 5, 10, 15, and 20mm to create treatable plans. Pinnacle 9.10v was used for planning purposes. A total of 12 cases were planned with varying multileaf collimator (MLC) widths. Treatment plans were evaluated retrospectively. Results show that altering the MLC widths from 5 through 20mm produces both comparable and treatable plans up to 99% and 98% target coverage for H&N and prostate, respectively, albeit clinically significant hot spots were shown to increase with increasing segment width. Furthermore, the results show that increasing widths can produce comparable treatment plans as measured against our current Food and Drug Administration (FDA)-approved treatment devices-leading to an increase in treatment efficacy in economically underdeveloped countries.
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: jonghanho@gmail.com.
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Ho
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Shane
authors.initials: S
authors.lastname: Hagler
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Carrie
authors.initials: C
authors.lastname: Lujano
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Sopaul
authors.initials: S
authors.lastname: Seng
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Christine
authors.initials: C
authors.lastname: Starks
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Kelly
authors.initials: K
authors.lastname: Perrin
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Lehendrick
authors.initials: L
authors.lastname: Turner
authors.affiliation: School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Laurence
authors.initials: L
authors.lastname: Court
mesh_terms: D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D059351:Organ Sparing Treatments; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control*; D050397:Radiotherapy, Intensity-Modulated / Q000191:economics* / Q000295:instrumentation*; D012189:Retrospective Studies
keywords: Cost; MLC (multileaf collimator) Segment Width; Underdeveloped countries; VMAT (volumetric modulated arc therapy)