Volumetric modulated arc therapy planning for distal oesophageal malignancies.

OBJECTIVES: Volumetric modulated arc therapy (VMAT) is a novel form of intensity-modulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. The capability of VMAT to reduce heart and cord dose, while maintaining lung r...

Full description

Bibliographic Details
Main Authors: Hawkins, M, Bedford, J, Warrington, A, Tait, D
Format: Journal article
Language:English
Published: 2012
_version_ 1797050264467800064
author Hawkins, M
Bedford, J
Warrington, A
Tait, D
author_facet Hawkins, M
Bedford, J
Warrington, A
Tait, D
author_sort Hawkins, M
collection OXFORD
description OBJECTIVES: Volumetric modulated arc therapy (VMAT) is a novel form of intensity-modulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. The capability of VMAT to reduce heart and cord dose, while maintaining lung receiving 20 Gy <20%, was evaluated for chemoradiation for oesophageal cancer. METHODS: An optimised forward-planned four-field arrangement was compared with inverse-planned coplanar VMAT arcs with 35 control points for 10 patients with lower gastro-oesophageal tumours prescribed 54 Gy in 30 fractions. Conformal (cARC) and intensity-modulated (VMATi) arcs were considered. Plans were assessed and compared using the planning target volume (PTV) irradiated to 95% of the prescription dose (V95), volumes of lung irradiated to 20 Gy (V20), heart irradiated to 30 Gy (V30), spinal cord maximum dose and van't Riet conformation number (CN). The monitor units per fraction and delivery time were recorded for a single representative plan. RESULTS: VMATi provided a significant reduction in the heart V30 (31% vs 55%; p=0.02) with better CN (0.72 vs 0.65; p=0.01) than the conformal plan. The treatment delivery was 1 min 28 s for VMAT compared with 3 min 15 s. CONCLUSION: For similar PTV coverage, VMATi delivers a lower dose to organs at risk than conformal plans in a shorter time, and this has warranted clinical implementation.
first_indexed 2024-03-06T18:02:36Z
format Journal article
id oxford-uuid:0053f3f8-faae-482f-9217-3f9360b91f95
institution University of Oxford
language English
last_indexed 2024-03-06T18:02:36Z
publishDate 2012
record_format dspace
spelling oxford-uuid:0053f3f8-faae-482f-9217-3f9360b91f952022-03-26T08:28:55ZVolumetric modulated arc therapy planning for distal oesophageal malignancies.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0053f3f8-faae-482f-9217-3f9360b91f95EnglishSymplectic Elements at Oxford2012Hawkins, MBedford, JWarrington, ATait, D OBJECTIVES: Volumetric modulated arc therapy (VMAT) is a novel form of intensity-modulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. The capability of VMAT to reduce heart and cord dose, while maintaining lung receiving 20 Gy <20%, was evaluated for chemoradiation for oesophageal cancer. METHODS: An optimised forward-planned four-field arrangement was compared with inverse-planned coplanar VMAT arcs with 35 control points for 10 patients with lower gastro-oesophageal tumours prescribed 54 Gy in 30 fractions. Conformal (cARC) and intensity-modulated (VMATi) arcs were considered. Plans were assessed and compared using the planning target volume (PTV) irradiated to 95% of the prescription dose (V95), volumes of lung irradiated to 20 Gy (V20), heart irradiated to 30 Gy (V30), spinal cord maximum dose and van't Riet conformation number (CN). The monitor units per fraction and delivery time were recorded for a single representative plan. RESULTS: VMATi provided a significant reduction in the heart V30 (31% vs 55%; p=0.02) with better CN (0.72 vs 0.65; p=0.01) than the conformal plan. The treatment delivery was 1 min 28 s for VMAT compared with 3 min 15 s. CONCLUSION: For similar PTV coverage, VMATi delivers a lower dose to organs at risk than conformal plans in a shorter time, and this has warranted clinical implementation.
spellingShingle Hawkins, M
Bedford, J
Warrington, A
Tait, D
Volumetric modulated arc therapy planning for distal oesophageal malignancies.
title Volumetric modulated arc therapy planning for distal oesophageal malignancies.
title_full Volumetric modulated arc therapy planning for distal oesophageal malignancies.
title_fullStr Volumetric modulated arc therapy planning for distal oesophageal malignancies.
title_full_unstemmed Volumetric modulated arc therapy planning for distal oesophageal malignancies.
title_short Volumetric modulated arc therapy planning for distal oesophageal malignancies.
title_sort volumetric modulated arc therapy planning for distal oesophageal malignancies
work_keys_str_mv AT hawkinsm volumetricmodulatedarctherapyplanningfordistaloesophagealmalignancies
AT bedfordj volumetricmodulatedarctherapyplanningfordistaloesophagealmalignancies
AT warringtona volumetricmodulatedarctherapyplanningfordistaloesophagealmalignancies
AT taitd volumetricmodulatedarctherapyplanningfordistaloesophagealmalignancies