Sang-Tae Kim1, Hyun Joon An2,3,4,5, Jung-In Kim2,3,4, Jae-Ryong Yoo6, Hak Jae Kim2,3,4,7, Jong Min Park2,3,4,8. 1. Nuclear Emergency Division, Radiation Protection and Emergency Preparedness Bureau, Nuclear Safety and Security Commission, Seoul, Korea. 2. Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea. 3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea. 4. Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea. 5. Department of Biomedical Sciences, Seoul National University, Seoul, Korea. 6. Radiation Emergency Medicine Regulation Team, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea. 7. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. 8. Robotics Research Laboratory for Extreme Environments, Advanced Institute of Convergence Technology, Suwon, Korea.
Abstract
OBJECTIVE: This study aimed to compare the plan quality of non-coplanar partial arc (NPA) volumetric modulated arc therapy (VMAT) to that of coplanar partial arc (CPA) VMAT for stereotactic ablative radiotherapy (SABR) for lung cancer. METHODS: A total of 20 patients treated for lung cancer with the SABR VMAT technique and whose lung tumors were close to the heart were retrospectively selected for this study. For the CPA VMAT, three coplanar half arcs were used while two coplanar half arcs and one noncoplanar arc rotating 315°-45° with couch rotations of 315° ± 5° were used for the NPA VMAT. For each patient, identical CT image sets and identical structures were used for both the CPA and NPA VMAT plans. Dose-volumetric parameters of each plan were analyzed. RESULTS: For the planning target volume and both lungs, no statistically significant differences between the CPA and NPA VMAT plans were observed in general. For the heart, average values of D0.1cc of the CPA and NPA VMAT plans were 29.42 ± 13.37 and 21.71 ± 9.20 Gy, respectively (p < 0.001). For whole body, the mean dose and the gradient index of the CPA VMAT plans were 1.2 ± 0.5 Gy and 4.356 ± 0.608 while those of the NPA VMAT plans were 1.1 ± 0.5 Gy and 4.111 ± 0.480, respectively (both with p < 0.001). CONCLUSION: The NPA VMAT proposed in this study showed more favorable plan quality than the CPA VMAT plans for lung SABR with tumors located close to the heart. ADVANCES IN KNOWLEDGE: For lung SABR, NPA VMAT can reduce doses to the heart as well as whole-body irradiation.
OBJECTIVE: This study aimed to compare the plan quality of non-coplanar partial arc (NPA) volumetric modulated arc therapy (VMAT) to that of coplanar partial arc (CPA) VMAT for stereotactic ablative radiotherapy (SABR) for lung cancer. METHODS: A total of 20 patients treated for lung cancer with the SABR VMAT technique and whose lung tumors were close to the heart were retrospectively selected for this study. For the CPA VMAT, three coplanar half arcs were used while two coplanar half arcs and one noncoplanar arc rotating 315°-45° with couch rotations of 315° ± 5° were used for the NPA VMAT. For each patient, identical CT image sets and identical structures were used for both the CPA and NPA VMAT plans. Dose-volumetric parameters of each plan were analyzed. RESULTS: For the planning target volume and both lungs, no statistically significant differences between the CPA and NPA VMAT plans were observed in general. For the heart, average values of D0.1cc of the CPA and NPA VMAT plans were 29.42 ± 13.37 and 21.71 ± 9.20 Gy, respectively (p < 0.001). For whole body, the mean dose and the gradient index of the CPA VMAT plans were 1.2 ± 0.5 Gy and 4.356 ± 0.608 while those of the NPA VMAT plans were 1.1 ± 0.5 Gy and 4.111 ± 0.480, respectively (both with p < 0.001). CONCLUSION: The NPA VMAT proposed in this study showed more favorable plan quality than the CPA VMAT plans for lung SABR with tumors located close to the heart. ADVANCES IN KNOWLEDGE: For lung SABR, NPA VMAT can reduce doses to the heart as well as whole-body irradiation.
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