Assessing the role of volumetric‐modulated arc therapy in hepatocellular carcinoma
نویسندگان
چکیده
The role of volumetric-modulated arc therapy (VMAT) in hepatocellular carcinoma (HCC) remains controversial. The purpose of this study was to determine the potential clinical role of VMAT compared with three-dimensional conformal radiotherapy (3D CRT) for liver irradiation. Four-dimensional CT scans of 24patients with unresectable HCC were included and divided into two groups: (1) adjacent group (n = 11), with planning target volumes overlapping or within 1 cm adjacent to the alimentary tract; (2) nonadjacent group (n = 13), in which the normal liver itself was the dose-limiting structure. Target coverage, organs-at-risk (OARs) doses, delivery parameters, and treatment accuracy were evaluated. Superior target coverage, conformity, and homogeneity were achieved with VMAT compared with 3D CRT. In the adjacent group, VMAT provided superior sparing of serial functioning OARs including the stomach, small intestine, and spinal cord. In the nonadjacent group, VMAT provided inferior sparing of most OARs including the liver, stomach, and small intestine. For the whole group, the effective treatment time was 2.1 ± 0.3 min for 3D CRT and 3.1 ± 0.2 min for VMAT. For liver lesions adjacent to the alimentary tract, this study indicates that VMAT should be selected due to the plan quality, delivery efficiency, and superior sparing of stomach and small intestine. However, for liver lesions away from the alimentary tract, VMAT is not superior to 3D CRT for normal tissue protection.
منابع مشابه
Dosimetric influence of Flattening Filter (FF) and Flattening Filter Free (FFF) 6 and 10 MV photon beams on Volumetric Modulated Arc Therapy (VMAT) planning in case of prostate carcinoma
Background: In the treatment of prostate cancer, radiotherapy is the potential to increase second primary cancers such as bladder and rectal cancers. The reasons for this potential are more monitor units (MUs), therefore a larger total body dose because of leakage radiation, a bigger volume of normal tissue is exposed to lower radiation doses. This study was designed to compare the integral dos...
متن کاملQuantification and modelling of the dosimetric impact of the treatment couch in volumetric modulated arc therapy (VMAT)
Background: As the volumetric modulated arc therapy (VMAT) becoming a main role of treatment ways, the effect of couch top becomes more significant. It is imperative to re-evaluate the couches that previously may have been considered of no importance during early treatment techniques. The impact of couch top on radiation delivery was explored and the couch model was tested with the aim of reduc...
متن کاملDosimetric Evaluation of Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Radiotherapy (IMRT) Using AAPM TG 119 Protocol
Background: The commissioning accuracy of Volumetric Modulated Arc Therapy (VMAT) need to be evaluated.Objective: To test and evaluate commissioning accuracy of VMAT based on the TG 119 protocols at local institution. Material and Methods: The phantom, structure sets, VMAT and IMRT beam parameter setup, dose prescriptions and planning objectives were following TG 119 guidelines to c...
متن کاملPerformance evaluation of gated volumetric modulated arc therapy
Background: Aim of this study is to evaluate the accuracy of the gated volumetric modulated arc therapy (VMAT/RapidArc) using 2D planar dosimetry, DynaLog files and COMPASS 3D dosimetry system. Materials and Methods: Pre-treatment quality assurance of 10 gated VMAT plans was verified using 2D array and COMPASS 3D dosimetry system. Advantage of COMPASS over 2D planar is that it provides the clin...
متن کاملEarly toxicity of moderate hypofractionated volumetric modulated Arc radiotherapy for localized prostate cancer
Background: Based on the radiation biology model of prostate cancer, hypofractionated radiotherapy can improve the treatment outcomes without increasing toxicity. Although hypofractionated radiotherapy is implemented over a short period of time, it is more convenient and cheaper compared with conventional fractionated treatment. The aim of this study was to investigate the early toxicity of mod...
متن کامل