scholarly journals Delivery Parameter Variations and Early Clinical Outcomes of Volumetric Modulated Arc Therapy for 31 Prostate Cancer Patients: An Intercomparison of Three Treatment Planning Systems

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Shinichi Tsutsumi ◽  
Masako N. Hosono ◽  
Daisaku Tatsumi ◽  
Yoshitaka Miki ◽  
Yutaka Masuoka ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Volumetric Modulated Arc Therapy ◽  
Planning Systems ◽  
Treatment Planning Systems ◽  
Dose Volume ◽  
Parameter Variations ◽  
Arc Therapy ◽  
The Mean ◽  
Mean Dose Rate ◽  
Early Clinical Outcomes

We created volumetric modulated arc therapy (VMAT) plans for 31 prostate cancer patients using one of three treatment planning systems (TPSs)—ERGO++, Monaco, or Pinnacle—and then treated those patients. A dose of 74 Gy was prescribed to the planning target volume (PTV). The rectum, bladder, and femur were chosen as organs at risk (OARs) with specified dose-volume constraints. Dose volume histograms (DVHs), the mean dose rate, the beam-on time, and early treatment outcomes were evaluated and compared. The DVHs calculated for the three TPSs were comparable. The mean dose rates and beam-on times for Ergo++, Monaco, and SmartArc were, respectively, 174.3 ± 17.7, 149.7 ± 8.4, and 185.8 ± 15.6 MU/min and 132.7 ± 8.4, 217.6 ± 13.1, and 127.5 ± 27.1 sec. During a follow-up period of 486.2 ± 289.9 days, local recurrence was not observed, but distant metastasis was observed in a single patient. Adverse events of grade 3 to grade 4 were not observed. The mean dose rate for Monaco was significantly lower than that for ERGO++ and SmartArc (P<0.0001), and the beam-on time for Monaco was significantly longer than that for ERGO++ and SmartArc (P<0.0001). Each TPS was successfully used for prostate VMAT planning without significant differences in early clinical outcomes despite significant TPS-specific delivery parameter variations.

scholarly journals Comparison between two treatment planning systems for volumetric modulated arc therapy optimization for prostate cancer

2014 ◽  
Vol 30 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Caroline Lafond ◽  
Frédéric Gassa ◽  
Christophe Odin ◽  
Gaël Dréan ◽  
Justine Even ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Treatment Planning ◽  
Volumetric Modulated Arc Therapy ◽  
Planning Systems ◽  
Treatment Planning Systems ◽  
Arc Therapy

scholarly journals Treatment planning comparison of volumetric modulated arc therapy with Trilogy and Halcyon for bilateral breast cancer

2021 ◽  
Author(s):  
Tao Sun ◽  
Xiutong Lin ◽  
Guifang Zhang ◽  
Qingtao Qiu ◽  
Chengqiang Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Planning ◽  
Volumetric Modulated Arc Therapy ◽  
Bilateral Breast Cancer ◽  
Planning System ◽  
Skin Dose ◽  
Delivery Time ◽  
Dose Volume ◽  
Arc Therapy ◽  
The Mean

Abstract Background: The Halcyon is a new machine from the Varian company. The purpose of this study was to evaluate the dosimetry of the Halcyon in treatment of bilateral breast cancer with volumetric modulated arc therapy. Methods: On CT images of 10 patients with bilateral breast cancer, four Halcyon plans with different setup fields were generated, and dosimetric comparisons using Bonferroni’s multiple comparisons test were conducted among the four plans. Whole and partial arc plans on the Trilogy and the Halcyon, referred to as T-4arc, T-8arc, H-4arc and H-8arc, were designed. The prescription dose was 50 Gy in 2-Gy fractions. All plans were designed with the Eclipse version 15.5 treatment planning system. The dosimetric differences between whole and partial arc plans in the same accelerator were compared using the Mann-Whitney U test. The better Halcyon plan was selected for the further dosimetric comparison of the plan quality and delivery efficiency between the Trilogy and the Halcyon. Results:Halcyon plans with high‐quality megavoltage cone beam CT setup fields increased the Dmean, D2 and V107 of the planning target volume (PTV) and the V5 and Dmean of the heart, left ventricle (LV) and lungs compared with other Halcyon setup plans. The mean dose and low dose volume of the heart, lungs and liver were significantly decreased in T-8arc plans compared to T-4arc plans. In terms of the V5, V20, V30, V40 and Dmean of the heart, the V20, V30, V40 and Dmean of the LV, the V30, V40, Dmax and Dmean of the left anterior descending artery (LAD), and the V5 and V40 of lungs, H-8arc was significantly higher than H-4arc (p<0.05). Compared with the Trilogy’s plans, the Halcyon’s plans reduced the high-dose volume of the heart and LV but increased the mean dose of the heart. For the dose of the LAD and the V20 and V30 of lungs, there was no significant difference between the two accelerators. Compared with the Trilogy, plans on the Halcyon significantly increased the skin dose but also significantly reduced the delivery time. Conclusion: For the Halcyon, the whole-arc plans have more dosimetric advantages than partial-arc plans in bilateral breast cancer radiotherapy. Although the mean dose of the heart and the skin dose are increased, the doses of the cardiac substructure and other OARs are comparable to the Trilogy, and the delivery time is significantly reduced.

scholarly journals Treatment planning comparison of volumetric modulated arc therapy with the trilogy and the Halcyon for bilateral breast cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tao Sun ◽  
Xiutong Lin ◽  
Guifang Zhang ◽  
Qingtao Qiu ◽  
Chengqiang Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Planning ◽  
Volumetric Modulated Arc Therapy ◽  
Bilateral Breast Cancer ◽  
Planning System ◽  
Skin Dose ◽  
Delivery Time ◽  
Dose Volume ◽  
Arc Therapy ◽  
The Mean

Abstract Background The Halcyon is a new machine from the Varian company. The purpose of this study was to evaluate the dosimetry of the Halcyon in treatment of bilateral breast cancer with volumetric modulated arc therapy. Methods On CT images of 10 patients with bilateral breast cancer, four Halcyon plans with different setup fields were generated, and dosimetric comparisons using Bonferroni’s multiple comparisons test were conducted among the four plans. Whole and partial arc plans on the Trilogy and the Halcyon, referred to as T-4arc, T-8arc, H-4arc and H-8arc, were designed. The prescription dose was 50 Gy in 2-Gy fractions. All plans were designed with the Eclipse version 15.5 treatment planning system. The dosimetric differences between whole and partial arc plans in the same accelerator were compared using the Mann–Whitney U test. The better Halcyon plan was selected for the further dosimetric comparison of the plan quality and delivery efficiency between the Trilogy and the Halcyon. Results Halcyon plans with high‐quality megavoltage cone beam CT setup fields increased the Dmean, D2 and V107 of the planning target volume (PTV) and the V5 and Dmean of the heart, left ventricle (LV) and lungs compared with other Halcyon setup plans. The mean dose and low dose volume of the heart, lungs and liver were significantly decreased in T-8arc plans compared to T-4arc plans. In terms of the V5, V20, V30, V40 and Dmean of the heart, the V20, V30, V40 and Dmean of the LV, the V30, V40, Dmax and Dmean of the left anterior descending artery (LAD), and the V5 and V40 of lungs, H-8arc was significantly higher than H-4arc (p < 0.05). Compared with the Trilogy’s plans, the Halcyon’s plans reduced the high-dose volume of the heart and LV but increased the mean dose of the heart. For the dose of the LAD and the V20 and V30 of lungs, there was no significant difference between the two accelerators. Compared with the Trilogy, plans on the Halcyon significantly increased the skin dose but also significantly reduced the delivery time. Conclusion For the Halcyon, the whole-arc plans have more dosimetric advantages than partial-arc plans in bilateral breast cancer radiotherapy. Although the mean dose of the heart and the skin dose are increased, the doses of the cardiac substructure and other OARs are comparable to the Trilogy, and the delivery time is significantly reduced.

scholarly journals Adaptive Imaging Versus Periodic Surveillance for Intrafraction Motion Management During Prostate Cancer Radiotherapy

2019 ◽  
Vol 18 ◽  
pp. 153303381984448
Author(s):  
Xiangyu Ma ◽  
Huagang Yan ◽  
Ravinder Nath ◽  
Zhe Chen ◽  
Haiyun Li ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Volumetric Modulated Arc Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Additional Patient ◽  
Automatic Correction ◽  
Adaptive Imaging ◽  
Intensity Modulated ◽  
Arc Therapy ◽  
The Mean

Objective: To evaluate the benefits of adaptive imaging with automatic correction compared to periodic surveillance strategies with either manual or automatic correction. Methods: Using Calypso trajectories from 54 patients with prostate cancer at 2 institutions, we simulated 5-field intensity-modulated radiation therapy and dual-arc volumetric-modulated arc therapy with periodic imaging at various frequencies and with continuous adaptive imaging, respectively. With manual/automatic correction, we assumed there was a 30/1 second delay after imaging to determine and apply couch shift. For adaptive imaging, real-time “dose-free” cine-MV images during beam delivery are used in conjunction with online-updated motion pattern information to estimate 3D displacement. Simultaneous MV-kV imaging is only used to confirm the estimated overthreshold motion and calculate couch shift, hence very low additional patient dose from kV imaging. Results: Without intrafraction intervention, the prostates could on average have moved out of a 3-mm margin for ∼20% of the beam-on time after setup imaging in current clinical situation. If the time interval from the setup imaging to beam-on can be reduced to only 30 seconds, the mean over-3 mm percentage can be reduced to ∼7%. For intensity-modulated radiation therapy simulation, with manual correction, 110 and 70 seconds imaging periods both reduced the mean over-3 mm time to ∼4%. Automatic correction could give another 1% to 2% improvement. However, with either manual or automatic correction, the maximum patient-specific over-3 mm time was still relatively high (from 6.4% to 12.6%) and those patients are actually clinically most important. In contrast, adaptive imaging with automatic intervention significantly reduced the mean percentage to 0.6% and the maximum to 2.7% and averagely only ∼1 kV image and ∼1 couch shift were needed per fraction. The results of volumetric-modulated arc therapy simulation show a similar trend to that of intensity-modulated radiation therapy. Conclusions: Adaptive continuous monitoring with automatic motion compensation is more beneficial than periodic imaging surveillance at similar or even less imaging dose.

scholarly journals Treatment Planning Comparison of Volumetric Modulated Arc Therapy With Trilogy and Halcyon for Bilateral Breast Cancer 

2020 ◽  
Author(s):  
Tao Sun ◽  
Xiutong Lin ◽  
Guifang Zhang ◽  
Qingtao Qiu ◽  
Chengqiang Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Volumetric Modulated Arc Therapy ◽  
Bilateral Breast Cancer ◽  
Skin Dose ◽  
High Dose ◽  
Delivery Time ◽  
Breast Cancer Radiotherapy ◽  
Dose Volume ◽  
Arc Therapy ◽  
The Mean

Abstract Background: To evaluate the dosimetry of Halcyon in treatment of bilateral breast cancer with volumetric modulated arc therapy. Methods: On CT images of 10 patients with bilateral breast cancer, four Halcyon plans with different setup fields were generated and dosimetric comparisons were conducted among the four plans to select an optimal setup field mode. The four setup-field plans were referred to as CBCT-H, CBCT-L, MV-H, MV-L. Whole and partial arc plans on Trilogy and Halcyon referred to as T-4arc, T-8arc, H-4arc and H-8arc were designed. The dosimetric differences between whole and partial arc plans in the same accelerator were compared to understand the most suitable field setting mode. The better Halcyon plan was selected to the further dosimetric comparison of the plan quality and delivery efficiency between Trilogy and Halcyon. Results: CBCT-H plans increased Dmean, D2 and V107 of planning target volume (PTV) and V5 and Dmean of the heart, left ventricle (LV) and lungs compared to other plans. No significantly dosimetric differences were observed in PTV and organs at risk (OARs) among CBCT-L, MV-H and MV-L. The mean dose and low dose volume of heart, lungs and liver were significantly decreased in T-8arc plans. In terms of V5, V20, V30, V40 and Dmean of the heart, V20, V30, V40 and Dmean of the LV, V30, V40, Dmax and Dmean of the left anterior descending artery (LAD), V5 and V40 of lungs, H-8arc was significantly higher than H-4arc (p<0.05). Compared to Trilogy’s plans, Halcyon’s plans reduced the high-dose volume of the heart and LV, but increased the mean dose of the heart. For the dose of the LAD and the V20, V30 of lungs, there was no statistical difference between the two accelerators. Compared with Trilogy, plans on Halcyon significantly increased the skin dose, but also significantly reduced the delivery time. Conclusion: For Halcyon, the whole-arc plans has more dosimetric advantages in bilateral breast cancer radiotherapy. Although the mean dose of the heart and the skin dose are increased, the dose of the cardiac substructure and other OARs are comparable to the Trilogy, and the delivery time is significantly reduced.

Dosimetric comparison of RapidPlan and manually optimised volumetric modulated arc therapy plans in prostate cancer

2020 ◽  
pp. 1-8
Author(s):  
Loyce M. H. Chua ◽  
Eric P. P. Pang ◽  
Zubin Master ◽  
Rehena Sultana ◽  
Jeffrey K. L. Tuan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Target Volume ◽  
Plan Quality ◽  
Planning Time ◽  
Arc Therapy ◽  
Treatment Plans ◽  
The Mean ◽  
Time Required

Abstract Purpose: The aim of this study was to evaluate whether RapidPlan (RP) could generate clinically acceptable prostate volumetric modulated arc therapy (VMAT) plans. Methods: The in-house RP model was used to generate VMAT plans for 50 previously treated prostate cancer patients, with no additional optimisation being performed. The VMAT plans that were generated using the RP model were compared with the patients’ previous, manually optimised clinical plans (MP), none of which had been used for the development of the in-house RP prostate model. Differences between RP and MP in planning target volume (PTV) doses, organs at risk (OAR) sparing, monitor units (MU) and planning time required to produce treatment plans were analysed. Assessment of PTV doses was based on the conformation number (CN), homogeneity index (HI), D2%, D99% and the mean dose of the PTV. The OAR doses evaluated were the rectal V50 Gy, V65 Gy, V70 Gy and the mean dose, the bladder V65 Gy, V70 Gy and the mean dose, and the mean dose to both femurs. Results: D99% and mean dose of the PTV were lower for RP than for MP (p = 0·006 and p = 0·040, respectively).V50 Gy, V65 Gy and the mean dose to rectum were lower in RP than in MP (p < 0·001). V65 Gy, V70 Gy and the mean dose to bladder were lower in RP than in MP (p < 0·001). RP had enhanced the sparing of both femurs (p < 0·001) and significantly reduced the planning time to less than 5% of the time taken with MP. MU in RP was significantly higher than MP by an average of 52·5 MU (p < 0·001) and 46 out of the 50 RP plans were approved by the radiation oncologist. Conclusion: This study has demonstrated that VMAT plans generated using an in-house RP prostate model in a single optimisation for prostate patients were clinically acceptable with comparable or better plan quality compared to MP. RP can add value and improve treatment planning efficiency in a high-throughput radiotherapy department through reduced plan optimisation time while maintaining consistency in the plan quality.

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