Karunakaran Balaji1, Poonam Yadav2, Sitaraman BalajiSubramanian3, Chandrasekaran Anu Radha4, Velayudham Ramasubramanian4. 1. Department of Radiation Oncology, Gleneagles Global Hospitals, Chennai, India; School of Advanced Sciences, Vellore Institute of Technology, Vellore, India. Electronic address: karthik.balaji85@gmail.com. 2. Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States. 3. Department of Radiation Oncology, Gleneagles Global Hospitals, Chennai, India. 4. School of Advanced Sciences, Vellore Institute of Technology, Vellore, India.
Abstract
PURPOSE: To find the optimal dose weighting for hybrid volumetric modulated arc therapy (H-VMAT), a combination of conventional 3DCRT and VMAT plans for left sided chest wall and supraclavicular radiation therapy. METHODS & MATERIALS: 20 left-sided breast cancer patients who received adjuvant radiotherapy were considered for this study. To find the optimal weighting, 5 H-VMAT plans were generated for each study case by combining different dose proportions of 3DCRT and VMAT plans including: 90% 3DCRT/10% VMAT, 80% 3DCRT/20% VMAT, 70% 3DCRT/30% VMAT, 60% 3DCRT/40% VMAT, 50% 3DCRT/50% VMAT. Further field-in-field, optimal H-VMAT and VMAT alone plans were compared. RESULTS: All H-VMAT plans achieved the expected target coverage. A higher conformity index was achieved for 50% 3DCRT/50% VMAT plan, while better homogeneity index was achieved for 80% 3DCRT/20% VMAT plan. Mean and low doses were less in 90% 3DCRT/10% VMAT plan. Compared with other proportions, 80% 3DCRT/20% VMAT and 70% 3DCRT/30% VMAT weighted H-VMAT plans achieved balanced results for PTVs and OARs. CONCLUSION: The optimal dose mixture for H-VMAT technique is 70% to 80% for 3DCRT and 20% to 30% for VMAT. The optimal H-VMAT achieved balanced results for the PTVs and OARs compared with field-in-field and VMAT alone plans.
PURPOSE: To find the optimal dose weighting for hybrid volumetric modulated arc therapy (H-VMAT), a combination of conventional 3DCRT and VMAT plans for left sided chest wall and supraclavicular radiation therapy. METHODS & MATERIALS: 20 left-sided breast cancerpatients who received adjuvant radiotherapy were considered for this study. To find the optimal weighting, 5 H-VMAT plans were generated for each study case by combining different dose proportions of 3DCRT and VMAT plans including: 90% 3DCRT/10% VMAT, 80% 3DCRT/20% VMAT, 70% 3DCRT/30% VMAT, 60% 3DCRT/40% VMAT, 50% 3DCRT/50% VMAT. Further field-in-field, optimal H-VMAT and VMAT alone plans were compared. RESULTS: All H-VMAT plans achieved the expected target coverage. A higher conformity index was achieved for 50% 3DCRT/50% VMAT plan, while better homogeneity index was achieved for 80% 3DCRT/20% VMAT plan. Mean and low doses were less in 90% 3DCRT/10% VMAT plan. Compared with other proportions, 80% 3DCRT/20% VMAT and 70% 3DCRT/30% VMAT weighted H-VMAT plans achieved balanced results for PTVs and OARs. CONCLUSION: The optimal dose mixture for H-VMAT technique is 70% to 80% for 3DCRT and 20% to 30% for VMAT. The optimal H-VMAT achieved balanced results for the PTVs and OARs compared with field-in-field and VMAT alone plans.
Authors: Alexander Venjakob; Michael Oertel; Dominik Alexander Hering; Christos Moustakis; Uwe Haverkamp; Hans Theodor Eich Journal: Strahlenther Onkol Date: 2020-10-17 Impact factor: 3.621