Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC)
Objectives: This study aimed to find the optimal radiotherapy VMAT plans, that achieved high conformity and homogeneity to the planned target volume (PTV), and minimize the dose to nearby organs at risk including the non-PTV lung, heart and oesophagus for patients with centrally located non-small Ce...
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MDPI AG
2021-10-01
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| Online Access: | https://www.mdpi.com/2075-1729/11/10/1085 |
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| author | Eva Y. W. Cheung Virginia H. Y. Kwong Fandy Y. C. Chan Dominic Y. T. Cheng Janice K. Y. Cheng Sapphire H. Y. Yung Kiris T. K. Chan Kelly T. Y. Cheung Tracy S. W. Cheung Janna C. L. Yiu |
| author_facet | Eva Y. W. Cheung Virginia H. Y. Kwong Fandy Y. C. Chan Dominic Y. T. Cheng Janice K. Y. Cheng Sapphire H. Y. Yung Kiris T. K. Chan Kelly T. Y. Cheung Tracy S. W. Cheung Janna C. L. Yiu |
| author_sort | Eva Y. W. Cheung |
| collection | DOAJ |
| description | Objectives: This study aimed to find the optimal radiotherapy VMAT plans, that achieved high conformity and homogeneity to the planned target volume (PTV), and minimize the dose to nearby organs at risk including the non-PTV lung, heart and oesophagus for patients with centrally located non-small Cell Lung Cancer. Methods: A total of 18 patients who were treated for stage III centrally located non-small Cell Lung Cancer were selected retrospectively for this study. Identical CT datasets, 4D CT and structure dataset were used for radiotherapy planning based on single-planar VMAT (SP-VMAT), dual-planar VMAT (DP-VMAT) and Hybrid VMAT (H-VMAT). For SP-VMAT, one full arc and two half arcs were created on single-plane with couch at 0°. For DP-VMAT, one full arc was created with couch at 0°, and two half arcs with couch rotation of 330° or 30°. For H-VMAT, anterior-posterior opposing fixed beam and two half arcs were planned at couch at 0°. Dose constraints were adhered to the RTOG0617. Dose volumetric parameters were collected for statistical analysis. Results: There were no significant differences for the PTV, HI, CI between the SP-VMAT, DP-VMAT and H-VMAT. For the non-PTV lungs, Dmean, V20, V10, V5, D1500 and D1000 were significantly lower (2.05 Gy, 6.47%, 15.89%, 11.66% 4.17 Gy and 5.47 Gy respectively) in H-VMAT than that of SP-VMAT (all <i>p</i> < 0.001). For the oesophagus, Dmax, Dmean, V30 and V18.8 of H-VMAT were 0.08 Gy, 1.73 Gy, 5.54% and 7.17% lower than that of the SP-VMAT plan. For the heart, Dmean, V34, V28, V20 and V10 of DP-VMAT were lower than that of SP-VMAT by 1.45 Gy, 0.65%, 1.74%, 4.8% and 7.11% respectively. Conclusion: The proposed H-VMAT showed more favourable plan quality than the SP-VMAT for centrally located stage III NSCLC, in particular for non-PTV lungs and the oesophagus. It will benefit patients, especially those who planned for immunotherapy (Durvalumab) after standard chemo-irradiation. The proposed DP-VMAT plan showed significant dose reduction to the heart when compared to the H-VMAT plan. |
| first_indexed | 2024-03-10T06:26:35Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-10T06:26:35Z |
| publishDate | 2021-10-01 |
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| series | Life |
| spelling | doaj.art-0e3d69bfe58f42ce9acc3e37776175432023-11-22T18:53:20ZengMDPI AGLife2075-17292021-10-011110108510.3390/life11101085Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC)Eva Y. W. Cheung0Virginia H. Y. Kwong1Fandy Y. C. Chan2Dominic Y. T. Cheng3Janice K. Y. Cheng4Sapphire H. Y. Yung5Kiris T. K. Chan6Kelly T. Y. Cheung7Tracy S. W. Cheung8Janna C. L. Yiu9School of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaDepartment of Clinical Oncology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaSchool of Medical Health and Sciences, Tung Wah College, 19/F, 31 Wylie Road, Ho Man Tin, Hong Kong, ChinaObjectives: This study aimed to find the optimal radiotherapy VMAT plans, that achieved high conformity and homogeneity to the planned target volume (PTV), and minimize the dose to nearby organs at risk including the non-PTV lung, heart and oesophagus for patients with centrally located non-small Cell Lung Cancer. Methods: A total of 18 patients who were treated for stage III centrally located non-small Cell Lung Cancer were selected retrospectively for this study. Identical CT datasets, 4D CT and structure dataset were used for radiotherapy planning based on single-planar VMAT (SP-VMAT), dual-planar VMAT (DP-VMAT) and Hybrid VMAT (H-VMAT). For SP-VMAT, one full arc and two half arcs were created on single-plane with couch at 0°. For DP-VMAT, one full arc was created with couch at 0°, and two half arcs with couch rotation of 330° or 30°. For H-VMAT, anterior-posterior opposing fixed beam and two half arcs were planned at couch at 0°. Dose constraints were adhered to the RTOG0617. Dose volumetric parameters were collected for statistical analysis. Results: There were no significant differences for the PTV, HI, CI between the SP-VMAT, DP-VMAT and H-VMAT. For the non-PTV lungs, Dmean, V20, V10, V5, D1500 and D1000 were significantly lower (2.05 Gy, 6.47%, 15.89%, 11.66% 4.17 Gy and 5.47 Gy respectively) in H-VMAT than that of SP-VMAT (all <i>p</i> < 0.001). For the oesophagus, Dmax, Dmean, V30 and V18.8 of H-VMAT were 0.08 Gy, 1.73 Gy, 5.54% and 7.17% lower than that of the SP-VMAT plan. For the heart, Dmean, V34, V28, V20 and V10 of DP-VMAT were lower than that of SP-VMAT by 1.45 Gy, 0.65%, 1.74%, 4.8% and 7.11% respectively. Conclusion: The proposed H-VMAT showed more favourable plan quality than the SP-VMAT for centrally located stage III NSCLC, in particular for non-PTV lungs and the oesophagus. It will benefit patients, especially those who planned for immunotherapy (Durvalumab) after standard chemo-irradiation. The proposed DP-VMAT plan showed significant dose reduction to the heart when compared to the H-VMAT plan.https://www.mdpi.com/2075-1729/11/10/1085non-small cell lung cancer (NSCLC)volumetric modulated arc therapycentrally locatedlungsoesophagusheart |
| spellingShingle | Eva Y. W. Cheung Virginia H. Y. Kwong Fandy Y. C. Chan Dominic Y. T. Cheng Janice K. Y. Cheng Sapphire H. Y. Yung Kiris T. K. Chan Kelly T. Y. Cheung Tracy S. W. Cheung Janna C. L. Yiu Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC) Life non-small cell lung cancer (NSCLC) volumetric modulated arc therapy centrally located lungs oesophagus heart |
| title | Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC) |
| title_full | Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC) |
| title_fullStr | Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC) |
| title_full_unstemmed | Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC) |
| title_short | Modified VMAT Plans for Locally Advanced Centrally Located Non-Small Cell Lung Cancer (NSCLC) |
| title_sort | modified vmat plans for locally advanced centrally located non small cell lung cancer nsclc |
| topic | non-small cell lung cancer (NSCLC) volumetric modulated arc therapy centrally located lungs oesophagus heart |
| url | https://www.mdpi.com/2075-1729/11/10/1085 |
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