Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy

Nima Nabavizadeh; Anna O. Simeonova; Joseph G. Waller; Jeanna L. Romer; Debra L. Monaco; David A. Elliott; James A. Tanyi; Martin Fuss; Charles R. Thomas; John M. Holland

doi:10.1016/j.meddos.2014.04.001

Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy

Nima Nabavizadeh, Anna O. Simeonova, Joseph G. Waller, Jeanna L. Romer, Debra L. Monaco, David A. Elliott, James A. Tanyi, Martin Fuss, Charles R. Thomas, John M. Holland

Radiation Medicine

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Volumetric-modulated arc radiotherapy (VMAT) is an iteration of intensity-modulated radiotherapy (IMRT), both of which deliver highly conformal dose distributions. Studies have shown the superiority of VMAT and IMRT in comparison with 3-dimensional conformal radiotherapy (3D-CRT) in planning target volume (PTV) coverage and organs-at-risk (OARs) sparing. This is the first study examining the benefits of VMAT in pancreatic cancer for doses more than 55.8. Gy. A planning study comparing 3D-CRT, IMRT, and VMAT was performed in 20 patients with pancreatic cancer. Treatments were planned for a 25-fraction delivery of 45. Gy to a large field followed by a reduced-volume 8-fraction external beam boost to 59.4. Gy in total. OARs and PTV doses, conformality index (CI) deviations from 1.0, monitor units (MUs) delivered, and isodose volumes were compared. IMRT and VMAT CI deviations from 1.0 for the large-field and the boost plans were equivalent (large field: 0.032 and 0.046, respectively; boost: 0.042 and 0.037, respectively; p > 0.05 for all comparisons). Both IMRT and VMAT CI deviations from 1.0 were statistically superior to 3D-CRT (large field: 0.217, boost: 0.177; p < 0.05 for all comparisons). VMAT showed reduction of the mean dose to the boost PTV (VMAT: 61.4. Gy, IMRT: 62.4. Gy, and 3D-CRT: 62.3. Gy; p < 0.05). The mean number of MUs per fraction was significantly lower for VMAT for both the large-field and the boost plans. VMAT delivery time was less than 3 minutes compared with 8 minutes for IMRT. Although no statistically significant dose reduction to the OARs was identified when comparing VMAT with IMRT, VMAT showed a reduction in the volumes of the 100% isodose line for the large-field plans. Dose escalation to 59.4. Gy in pancreatic cancer is dosimetrically feasible with shorter treatment times, fewer MUs delivered, and comparable CIs for VMAT when compared with IMRT.

Original language	English (US)
Pages (from-to)	256-260
Number of pages	5
Journal	Medical Dosimetry
Volume	39
Issue number	3
DOIs	https://doi.org/10.1016/j.meddos.2014.04.001
State	Published - 2014

Keywords

3D-CRT
IMRT
Pancreas
VMAT

ASJC Scopus subject areas

Radiological and Ultrasound Technology
Oncology
Radiology Nuclear Medicine and imaging

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10.1016/j.meddos.2014.04.001

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Nabavizadeh, N., Simeonova, A. O., Waller, J. G., Romer, J. L., Monaco, D. L., Elliott, D. A., Tanyi, J. A., Fuss, M., Thomas, C. R., & Holland, J. M. (2014). Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy. Medical Dosimetry, 39(3), 256-260. https://doi.org/10.1016/j.meddos.2014.04.001

Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy. / Nabavizadeh, Nima; Simeonova, Anna O.; Waller, Joseph G. et al.
In: Medical Dosimetry, Vol. 39, No. 3, 2014, p. 256-260.

Research output: Contribution to journal › Article › peer-review

Nabavizadeh, N, Simeonova, AO, Waller, JG, Romer, JL, Monaco, DL, Elliott, DA, Tanyi, JA, Fuss, M, Thomas, CR & Holland, JM 2014, 'Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy', Medical Dosimetry, vol. 39, no. 3, pp. 256-260. https://doi.org/10.1016/j.meddos.2014.04.001

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title = "Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy",

abstract = "Volumetric-modulated arc radiotherapy (VMAT) is an iteration of intensity-modulated radiotherapy (IMRT), both of which deliver highly conformal dose distributions. Studies have shown the superiority of VMAT and IMRT in comparison with 3-dimensional conformal radiotherapy (3D-CRT) in planning target volume (PTV) coverage and organs-at-risk (OARs) sparing. This is the first study examining the benefits of VMAT in pancreatic cancer for doses more than 55.8. Gy. A planning study comparing 3D-CRT, IMRT, and VMAT was performed in 20 patients with pancreatic cancer. Treatments were planned for a 25-fraction delivery of 45. Gy to a large field followed by a reduced-volume 8-fraction external beam boost to 59.4. Gy in total. OARs and PTV doses, conformality index (CI) deviations from 1.0, monitor units (MUs) delivered, and isodose volumes were compared. IMRT and VMAT CI deviations from 1.0 for the large-field and the boost plans were equivalent (large field: 0.032 and 0.046, respectively; boost: 0.042 and 0.037, respectively; p > 0.05 for all comparisons). Both IMRT and VMAT CI deviations from 1.0 were statistically superior to 3D-CRT (large field: 0.217, boost: 0.177; p < 0.05 for all comparisons). VMAT showed reduction of the mean dose to the boost PTV (VMAT: 61.4. Gy, IMRT: 62.4. Gy, and 3D-CRT: 62.3. Gy; p < 0.05). The mean number of MUs per fraction was significantly lower for VMAT for both the large-field and the boost plans. VMAT delivery time was less than 3 minutes compared with 8 minutes for IMRT. Although no statistically significant dose reduction to the OARs was identified when comparing VMAT with IMRT, VMAT showed a reduction in the volumes of the 100% isodose line for the large-field plans. Dose escalation to 59.4. Gy in pancreatic cancer is dosimetrically feasible with shorter treatment times, fewer MUs delivered, and comparable CIs for VMAT when compared with IMRT.",

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AU - Waller, Joseph G.

AU - Romer, Jeanna L.

AU - Monaco, Debra L.

AU - Elliott, David A.

AU - Tanyi, James A.

AU - Fuss, Martin

AU - Thomas, Charles R.

AU - Holland, John M.

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AB - Volumetric-modulated arc radiotherapy (VMAT) is an iteration of intensity-modulated radiotherapy (IMRT), both of which deliver highly conformal dose distributions. Studies have shown the superiority of VMAT and IMRT in comparison with 3-dimensional conformal radiotherapy (3D-CRT) in planning target volume (PTV) coverage and organs-at-risk (OARs) sparing. This is the first study examining the benefits of VMAT in pancreatic cancer for doses more than 55.8. Gy. A planning study comparing 3D-CRT, IMRT, and VMAT was performed in 20 patients with pancreatic cancer. Treatments were planned for a 25-fraction delivery of 45. Gy to a large field followed by a reduced-volume 8-fraction external beam boost to 59.4. Gy in total. OARs and PTV doses, conformality index (CI) deviations from 1.0, monitor units (MUs) delivered, and isodose volumes were compared. IMRT and VMAT CI deviations from 1.0 for the large-field and the boost plans were equivalent (large field: 0.032 and 0.046, respectively; boost: 0.042 and 0.037, respectively; p > 0.05 for all comparisons). Both IMRT and VMAT CI deviations from 1.0 were statistically superior to 3D-CRT (large field: 0.217, boost: 0.177; p < 0.05 for all comparisons). VMAT showed reduction of the mean dose to the boost PTV (VMAT: 61.4. Gy, IMRT: 62.4. Gy, and 3D-CRT: 62.3. Gy; p < 0.05). The mean number of MUs per fraction was significantly lower for VMAT for both the large-field and the boost plans. VMAT delivery time was less than 3 minutes compared with 8 minutes for IMRT. Although no statistically significant dose reduction to the OARs was identified when comparing VMAT with IMRT, VMAT showed a reduction in the volumes of the 100% isodose line for the large-field plans. Dose escalation to 59.4. Gy in pancreatic cancer is dosimetrically feasible with shorter treatment times, fewer MUs delivered, and comparable CIs for VMAT when compared with IMRT.

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Volumetric-modulated arc radiotherapy for pancreatic malignancies: Dosimetric comparison with sliding-window intensity-modulated radiotherapy and 3-dimensional conformal radiotherapy

Abstract

Keywords

ASJC Scopus subject areas

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