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Dosimetric comparison of volumetric modulated arc therapy and intensity-modulated radiation therapy for liver stereotactic ablative body radiotherapy

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

The objectives of this study were to compare the dosimetric differences between volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) techniques in treatment planning for liver stereotactic ablative body radiation (SABR) and, secondly, to identify when alternative VMAT arc configurations could provide dosimetric gains.

Methods

Ten consecutive patients previously treated with IMRT to a single liver lesion were selected and planned retrospectively using VMAT while employing the same dose objectives and dose constraints. Differences in dose conformality, normal liver sparing, and organs at risk (OARs) doses were compared between the IMRT and corresponding single circumferential arc (SCA) VMAT plan for each patient. Relative dosimetric differences were quantified for each of eight alternative VMAT arc configurations.

Results

The VMAT SCA plans were associated with a 4.8 and 8.1 % improvement of the 95 % conformity index (p = 0.02) and the 50 % gradient index (p = 0.05), respectively. A trend toward significance was found for normal liver sparing and the dose to the adjacent OAR with SCA vs. IMRT. The optimal VMAT arc arrangement was a single ipsilateral 180 degree arc in patients having small (<2–3 cm) lesions away from OARs (excluding the liver), a combination of coplanar arc and non-coplanar partial arc for patients with lesions adjacent to two or more critical OARs and an SCA which was sufficient for the remaining patients.

Conclusion

VMAT planning for liver SABR provided measurably higher levels of dose conformality compared with IMRT. An ipsilateral partial arc, single circumferential arc, or circumferential arc with added non-coplanar partial arc proved to be the most promising arc configuration in the majority of patients.

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This study was not supported by any research grant.

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Conflict of interest

The authors declare that they have no competing interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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    Authors and Affiliations

    1. Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada

      Isabelle Thibault, William Chu, Joelle Helou, Darby Erler & Hans T. Chung

    2. Department of Medical Physics, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada

      Matt Wronski & Renée Korol

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    1. Isabelle Thibault
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    2. Matt Wronski
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    3. Renée Korol
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    5. Joelle Helou
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    7. Hans T. Chung
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    Correspondence to Hans T. Chung.

    Additional information

    Isabelle Thibault and Matt Wronski contributed equally to this work.

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    Thibault, I., Wronski, M., Korol, R. et al. Dosimetric comparison of volumetric modulated arc therapy and intensity-modulated radiation therapy for liver stereotactic ablative body radiotherapy. J Radiat Oncol 5, 63–69 (2016). https://doi.org/10.1007/s13566-015-0220-9

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    • DOI: https://doi.org/10.1007/s13566-015-0220-9

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