Document Detail

Volumetric modulated arc therapy planning for distal oesophageal malignancies.
MedLine Citation:
PMID:  21427179     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Volumetric modulated arc therapy (VMAT) is a novel form of intensity-modulated radiation therapy that allows the radiation dose to be delivered in a single gantry rotation using conformal or modulated fields. The capability of VMAT to reduce heart and cord dose, while maintaining lung receiving 20 Gy <20%, was evaluated for chemoradiation for oesophageal cancer.
METHODS: An optimised forward-planned four-field arrangement was compared with inverse-planned coplanar VMAT arcs with 35 control points for 10 patients with lower gastro-oesophageal tumours prescribed 54 Gy in 30 fractions. Conformal (cARC) and intensity-modulated (VMATi) arcs were considered. Plans were assessed and compared using the planning target volume (PTV) irradiated to 95% of the prescription dose (V95), volumes of lung irradiated to 20 Gy (V20), heart irradiated to 30 Gy (V30), spinal cord maximum dose and van't Riet conformation number (CN). The monitor units per fraction and delivery time were recorded for a single representative plan.
RESULTS: VMATi provided a significant reduction in the heart V30 (31% vs 55%; p=0.02) with better CN (0.72 vs 0.65; p=0.01) than the conformal plan. The treatment delivery was 1 min 28 s for VMAT compared with 3 min 15 s.
CONCLUSION: For similar PTV coverage, VMATi delivers a lower dose to organs at risk than conformal plans in a shorter time, and this has warranted clinical implementation.
M A Hawkins; J L Bedford; A P Warrington; D M Tait
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-03-22
Journal Detail:
Title:  The British journal of radiology     Volume:  85     ISSN:  1748-880X     ISO Abbreviation:  Br J Radiol     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-22     Completed Date:  2012-02-21     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0373125     Medline TA:  Br J Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  44-52     Citation Subset:  AIM; IM    
Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, Sutton, UK.
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MeSH Terms
Esophageal Neoplasms / pathology,  radiotherapy*
Heart / radiation effects
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted*
Radiotherapy, Intensity-Modulated*
Retrospective Studies
Spinal Cord / radiation effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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