Volumetric modulated arc therapy of head-and-neck cancer on a fast-rotating O-ring linac: Plan quality and delivery time comparison with a C-arm linac
Volumetric modulated arc therapy of head-and-neck cancer on a fast-rotating O-ring linac: Plan quality and delivery time comparison with a C-arm linac
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DOI：
10.1016/j.radonc.2018.04.021
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发表时间：
2018-09-01
影响因子：
5.7
通讯作者：
Depuydt, Tom
中科院分区：
文献类型：
--
作者：
Michiels, Steven;Poels, Kenneth;Depuydt, Tom
背景和目的：直线加速器在机架速度、叶片速度和剂量率方面的改进可能会提高体积调制弧治疗（VMAT）输送的时间效率。然而，通过更快的 VMAT 可实现的计划质量仍有待研究。在本研究中，将具有快速移动叶片的快速旋转 O 形环直线加速器与 C 臂直线加速器在头颈癌 (HNC) VMAT 的计划质量和交付时间方面进行比较。材料和方法：对于 30 名 HNC 患者，在 Halcyon 快速旋转 O 形环直线加速器上使用双弧 (HA2) 和三弧 (HA3) VMAT 并使用双弧 VMAT 进行治疗计划在 TrueBeam C 臂直线加速器 (TB2) 上。比较目标覆盖指标和并发症概率。使用螺旋二极管阵列测量的 3%/3 mm 伽玛指数分析来验证计划的交付。比较了体积图像采集和计划交付时间。结果：所有研究的 VMAT 技术都实现了目标覆盖目标。 HA2（中位数 103.7%，第 1-3 四分位数 [103.5%;104.0%]）和 HA3（103.2% [103.0%;103.7%）] 的加强体积 D2% 高于 TB2（102.6% [102.3%;103.0%）]，导致 HA2 和 HA3 的加强目标剂量异质性增加。 HA3。 HA2 和 TB2 之间的并发症概率相当，而与 TB2 相比，HA3 显示口干概率降低 (0.8% [0.2%;1.8%]) 和吞咽困难概率降低 (1.0% [0.2%;1.8%])。 HA2、HA3 和 TB2 的伽玛指数一致性分数从未低于 93.0%。 HA2 (1 m 24 s +/- 1 s) 和 HA3 (1 m 54 s +/- 1 s) 的体积成像和计划交付时间比 TB2 (2 m 47 s +/- 1 s) 更短。结论：对于 HNC 的 VMAT，快速旋转 O 形环直线加速器至少保持了 C 臂直线加速器上两个弧的计划质量，同时减少了图像采集和计划交付时间。 (C) 2018 Elsevier B.V. 保留所有权利。
Background and purpose: Linac improvements in gantry speed, leaf speed and dose rate may increase the time-efficiency of volumetric modulated arc therapy (VMAT) delivery. The plan quality achievable with faster VMAT however remains to be investigated. In this study, a fast-rotating O-ring linac with fast-moving leaves is compared with a C-arm linac in terms of plan quality and delivery time for VMAT of head-and-neck cancer (HNC).Material and methods: For 30 patients with HNC, treatment planning was performed using dual-arc (HA2) and triple-arc (HA3) VMAT on a Halcyon fast-rotating O-ring linac and using dual-arc VMAT on a TrueBeam C-arm linac (TB2). Target coverage metrics and complication probabilities were compared. Plan delivery was verified using 3%/3 mm gamma-index analysis of helical diode array measurements. Volumetric image acquisition and plan delivery times were compared.Results: All studied VMAT-techniques fulfilled the target coverage objectives. D2% to the boost volume was higher for HA2 (median 103.7%, 1st-3rd quartile [103.5%;104.0%]) and HA3 (103.2% [103.0%;103.7%)] than for TB2 (102.6% [102.3%;103.0%)], resulting in an increased boost target dose heterogeneity for HA2 and HA3. Complication probabilities were comparable between HA2 and TB2, while HA3 showed a xerostomia probability reduction (0.8% [0.2%;1.8%]) and dysphagia probability reduction (1.0% [0.2%;1.8%]) compared with TB2. Gamma-index agreement scores were never below 93.0% for HA2, HA3 and TB2. Volumetric imaging and plan delivery time was shorter for HA2 (1 m 24 s +/- 1 s) and HA3 (1 m 54 s +/- 1 s) than for TB2 (2 m 47 s +/- 1 s).Conclusion: For VMAT of HNC, the fast-rotating O-ring linac at least maintains the plan quality of two arcs on a C-arm linac while reducing the image acquisition and plan delivery time. (C) 2018 Elsevier B.V. All rights reserved.