A Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT) with Unflattened Beams to VMAT with Flattened Beams and Tomotherapy for Head and Neck Cancer
A Dosimetric Comparison of Volumetric Modulated Arc Therapy (VMAT) with Unflattened Beams to VMAT with Flattened Beams and Tomotherapy for Head and Neck Cancer
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DOI：
10.4172/2155-9619.1000274
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
T. Ogata;H. Nishimura;H. Mayahara;A. Harada;Yoshiro Matsuo;M. Nakayama;K. Uehara;S. Tsudou;Y. Ejima;R. Sasaki;T. Okayama
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作者：
T. Ogata;H. Nishimura;H. Mayahara;A. Harada;Yoshiro Matsuo;M. Nakayama;K. Uehara;S. Tsudou;Y. Ejima;R. Sasaki;T. Okayama
背景资料：本研究的目的是比较头颈部癌症的无平坦滤波器（FFF）射束（FFF-VMAT）体积调制式弧形治疗（VMAT）与平坦滤波器（FF）射束（FF-VMAT）和螺旋断层治疗（HT）的剂量分布和治疗效率。方法：选择10例鼻咽癌和口咽癌患者进行计划性对照研究。为每例患者创建三个治疗计划（双弧FFF-VMAT、双弧FF-VMAT和HT）。计划靶体积的三个处方剂量水平分别为69.96、60和54戈伊，分33次，采用同步积分增强技术。通过分析均匀性、一致性、危及器官剂量（OAR）、监测单元（MU）数量和交付计划所需的射束开启时间（BOT）来比较计划质量。结果：FFF-VMAT的靶区覆盖率和保留率与FFVMAT和HT基本相当。与FF-VMAT相比，FFF-VMAT和HT均显著增加MUs数量，而BOT与FFF-VMAT相同，但HT显著增加。结论：我们在这里提出的第一份报告，FFF-VMAT实现了可比的计划质量，更少的交付时间，FF-VMAT和HT在头颈部癌症。FFF-VMAT是临床实践中治疗头颈部癌症的一种高效可行的选择。
Background: The purpose of this study was to compare the dose distributions and treatment delivery efficiency of volumetric modulated arc therapy (VMAT) with flattening filter free (FFF) beams (FFF-VMAT) against VMAT with flattening filter (FF) beams (FF-VMAT) and Helical TomoTherapy (HT) for head and neck cancer. Methods: Ten patients with nasopharyngeal and oropharyngeal cancer were chosen for this planning comparison study. Three treatment plans (dual arc FFF-VMAT, dual arc FF-VMAT, and HT) were created for each patient. The three prescription dose levels of the planning target volumes were 69.96, 60, and 54 Gy in 33 fractions, using the simultaneous integrated boost technique. Comparisons of the plan quality were performed by analyzing the homogeneity, conformity, dose to the organs at risk (OARs), the number of monitor units (MUs), and beam-on time (BOT) necessary for delivering the plans. Results: The target coverage and sparing of the OARs for FFF-VMAT were almost equivalent to those for FFVMAT and HT. Compared to FF-VMAT, FFF-VMAT and HT significantly increased the number of MUs. The BOTs were the same for FFF-VMAT and FF-VMAT but significantly increased for HT. Conclusion: We here present the first report of FFF-VMAT achieving a comparable plan quality with less delivery time to that of FF-VMAT and HT in head and neck cancer. FFF-VMAT is a highly efficient and feasible option for the treatment of head and neck cancer in clinical practice.