Feasibility of constant dose rate VMAT in the treatment of nasopharyngeal cancer patients

Radiation Oncology

Xiance Jin¹  Yongqiang Zhou¹  Jinling Yi¹  Ce Han¹  Congying Xie¹  Haijiao Shang²  Wenliang Yu³ 

[1]Department of Radiotherapy and Chemotherapy, the 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China

[2]Research department of IPTA(Beijing) Investment Administration Co., Ltd, Beijing, China

[3]Radiation Oncology Department, Quzhou People¿s Hospital, No. 2 Zhongloudi Street, Quzhou 324000, China

关键词: Nasopharyngeal cancer;    Multicriteria optimization;    Variable dose rate;    Constant dose rate;    Volumetric-modulated arc therapy;   

Others  :  1151016
DOI  :  10.1186/s13014-014-0235-1

 received in 2014-07-16, accepted in 2014-10-12,  发布年份 2014

【 摘 要 】

Purpose

To investigate the feasibility of constant dose rate volumetric modulated arc therapy (CDR-VMAT) in the treatment of nasopharyngeal cancer (NPC) patients and to introduce rotational arc radiotherapy for linacs incapable of dose rate variation.

Materials and methods

Twelve NPC patients with various stages treated previously using variable dose rate (VDR) VMAT were enrolled in this study. CDR-VMAT, VDR-VMAT and mutlicriteria optimization (MCO) VMAT plans were generated for each patient on RayStation treatment planning system with identical objective functions and the dosimetric differences among these three planning schemes were evaluated and compared. Non dosimetric parameters of optimization time, delivery time and delivery accuracy were also evaluated.

Results

The planning target volume of clinical target volume (PTV-CTV) coverage of CDR-VMAT was a bit inferior to those of VDR- and MCO-VMAT. The V93 (p?=?0.01) and V95 (percent volume covered by isodose line) (p?=?0.04) for CDR-VMAT, VDR-VMAT and MCO-VMAT were 98.74%?±?0.31%, 99.76%?±?0.16%, 99.38%?±?0.43%, and 98.40%?±?0.48%, 99.53%?±?0.28%, 99.07%?±?0.52%, respectively. However, the CDR-VMAT showed a better dose homogeneity index (HI) (p?=?0.01) in PTV-CTV. No significant difference in other target coverage parameters was observed. There was no significant difference in OAR sparing among these three planning schemes except for a higher maximum dose (Dmax) on the brainstem for CDR-VMAT. The brainstem Dmax of CDR-VMAT, VDR-VMAT and MCO-VMAT were 54.26?±?3.21 Gy, 52.19?±?1.65 Gy, and 52.79?±?4.77 Gy, respectively. The average delivery time (p?

Conclusion

CDR-VMAT offers an additional option of rotational arc radiotherapy for linacs incapable of dose rate variation with a lower initial cost. Its plan quality was acceptable but should be thoroughly checked compared with VDR-VMAT and MCO-VMAT in the treatment of NPC.

【 授权许可】

   
2014 Yu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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