Volumetric modulated arc therapy is superior to conventional intensity modulated radiotherapy - a comparison among prostate cancer patients treated in an Australian centre

Radiation Oncology

Nastik Bhandari²  Lauren E Haydu¹  Guilin Liu²  Diana Ng²  Gerald B Fogarty² 

[1] Sydney Medical School, the University of Sydney, Sydney, NSW, Australia;Radiation Oncology Department, Mater Hospital, Crows Nest, NSW, Australia

关键词: health care cost;    Australia;    three-dimensional conformal radiotherapy;    Volumetric modulated arc therapy;    Intensity-modulated radiotherapy;   

Others  :  1223907
DOI  :  10.1186/1748-717X-6-108

 received in 2011-07-01, accepted in 2011-09-05,  发布年份 2011

【 摘 要 】

Background

Radiotherapy technology is expanding rapidly. Volumetric Modulated Arc Therapy (VMAT) technologies such as RapidArc^® (RA) may be a more efficient way of delivering intensity-modulated radiotherapy-like (IM) treatments. This study is an audit of the RA experience in an Australian department with a planning and economic comparison to IM.

Methods

30 consecutive prostate cancer patients treated radically with RA were analyzed. Eight RA patients treated definitively were then completely re-planned with 3D conformal radiotherapy (3D); and a conventional sliding window IM technique; and a new RA plan. The acceptable plans and their treatment times were compared and analyzed for any significant difference. Differences in staff costs of treatment were computed and analyzed.

Results

Thirty patients had been treated to date with eight being treated definitely to at least 74 Gy, nine post high dose brachytherapy (HDR) to 50.4Gy and 13 post prostatectomy to at least 64Gy. All radiotherapy courses were completed with no breaks. Acute rectal toxicity by the RTOG criteria was acceptable with 22 having no toxicity, seven with grade 1 and one had grade 2.

Of the eight re-planned patients, none of the 3D (three-dimensional conformal radiotherapy) plans were acceptable based on local guidelines for dose to organs at risk. There was no statistically significant difference in planning times between IM and RA (p = 0.792). IM had significantly greater MUs per fraction (1813.9 vs 590.2 p < 0.001), total beam time per course (5.2 vs 3.1 hours, p = 0.001) and average treatment staff cost per patient radiotherapy course ($AUD489.91 vs $AUD315.66, p = 0.001). The mean saving in treatment staff cost for RA treatment was $AUD174.25 per patient.

Conclusions

3D was incapable of covering a modern radiotherapy volume for the radical treatment of prostate cancer. These volumes can be treated via conventional IM and RA. RA was significantly more efficient, safe and cost effective than IM. VMAT technologies are a superior way of delivering IM-like treatments.

【 授权许可】

   
2011 Fogarty et al; licensee BioMed Central Ltd.

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