Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study
Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer: a planning study
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DOI：
10.1186/1748-717x-8-26
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发表时间：
2013-01-31
影响因子：
3.6
通讯作者：
van Vliet-Vroegindeweij, Corine
中科院分区：
文献类型：
--
作者：
Holt, Andrea;Van Gestel, Dirk;van Vliet-Vroegindeweij, Corine
背景：与静态束调强放射治疗 (IMRT) 相比，容积调制弧形治疗 (VMAT) 的主要优点是缩短了治疗时间，从而提高了患者的舒适度，并可能缩小了分次内的移动。本研究旨在对由多个机构执行的头颈癌 IMRT 和 VMAT 放射治疗计划进行独立于治疗计划者的比较，并基于相同的 CT 和轮廓数据。方法：五个机构使用 Pinnacle(3) 或 Oncentra Masterplan 为五名口咽癌患者生成 IMRT 和 VMAT 计划，并在 Elekta 直线加速器上交付。结果：同一患者和机构内的 VMAT 和 IMRT 计划的比较显示出明显更好的结果几乎所有 OAR 都可以使用 VMAT 进行保护。腮腺和口腔的平均剂量分别从 IMRT 的 27.2 Gy 和 39.4 Gy 减少到 VMAT 的 25.0 Gy 和 36.7 Gy。 IMRT 中 PTVboost 和 PTVtotal 95% 处方剂量的剂量一致性分别为 1.45 和 1.62，VMAT 中分别为 1.37 和 1.50。平均有效治疗时间从 IMRT 的 13: 15 分钟减少到 VMAT 的 5: 54 分钟。结论：独立于机构特定的优化策略，包含双弧的 VMAT 计划的质量优于包含 5-9 个波束端口的步进式 IMRT 计划，而 VMAT 的有效治疗实施时间缩短了约 50%。
Background: Compared to static beam Intensity-Modulated Radiation Therapy (IMRT), the main advantage of Volumetric Modulated Arc Therapy (VMAT) is a shortened delivery time, which leads to improved patient comfort and possibly smaller intra-fraction movements. This study aims at a treatment planner-independent comparison of radiotherapy treatment planning of IMRT and VMAT for head-and-neck cancer performed by several institutes and based on the same CT- and contouring data.Methods: Five institutes generated IMRT and VMAT plans for five oropharyngeal cancer patients using either Pinnacle(3) or Oncentra Masterplan to be delivered on Elekta linear accelerators.Results: Comparison of VMAT and IMRT plans within the same patient and institute showed significantly better sparing for almost all OARs with VMAT. The average mean dose to the parotid glands and oral cavity was reduced from 27.2 Gy and 39.4 Gy for IMRT to 25.0 Gy and 36.7 Gy for VMAT, respectively. The dose conformity at 95% of the prescribed dose for PTVboost and PTVtotal was 1.45 and 1.62 for IMRT and 1.37 and 1.50 for VMAT, respectively. The average effective delivery time was reduced from 13: 15 min for IMRT to 5: 54 min for VMAT.Conclusions: Independently of institution-specific optimization strategies, the quality of the VMAT plans including double arcs was superior to step-and-shoot IMRT plans including 5-9 beam ports, while the effective treatment delivery time was shortened by similar to 50% with VMAT.