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Comparison of volumetric-modulated arc therapy and intensity-modulated radiation therapy prostate cancer plans accounting for cold spots

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Abstract

This study compared dosimetric indices of volumetric-modulated arc therapy (VMAT) with intensity-modulated radiation therapy (IMRT) accounting for cold spots in prostate cancer plans. IMRT plans were retrospectively generated from 30 prostate cancer patients with ten cases for each risk group, who received VMAT plans. The mean, maximum, and minimum doses, and conformity and homogeneity indexes were evaluated for planning target volume (PTV) and the mean dose and V20–V70 for organs at risk (OAR) including the rectum, bladder, right and left femoral heads, and rectum overlapped with PTV (ROP) regions. The numbers and volume percentages of cold spots within PTVs and ROP regions were measured using in-house software. Three-dimensional probabilistic distributions of the probability and distributions of cold spots were generated using a centroid matching technique for visualization and analysis. There was a statistically better dose conformity in the PTV, rectum, and bladder dose-sparing in VMAT compared to that in the IMRT plans, whereas VMAT had statistically worse target dose homogeneity, and right and left femoral head dose-sparing than those of the IMRT plans. The average volume percentage of cold spots per PTV for the VMAT was 4.37 ± 2.68%, which was smaller than the 5.72 ± 1.84% observed for IMRT plans (P = 0.007). The volume percentage of cold spots per ROP for the VMAT did not significantly differ from those for the IMRT plans. Compared with IMRT, the VMAT plans achieved better PTV dose conformity, OAR dose-sparing, and smaller cold spots in the treatment of prostate cancer.

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Acknowledgements

Funding was provided by Japan Society for the Promotion of Science (Grant no: 16J04075).

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Authors and Affiliations

  1. Division of Medical Quantum Science, Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Tran Thi Thao Nguyen, Ryosuke Asamura & Taka-aki Hirose

  2. Division of Medical Quantum Science, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Hidetaka Arimura & Saiji Ohga

  3. Department of Medical Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Taka-aki Hirose & Jun-ichi Fukunaga

  4. Japan Society for the Promotion of Science, 5-3-1, Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan

    Tran Thi Thao Nguyen

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  1. Tran Thi Thao Nguyen
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  2. Hidetaka Arimura
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Correspondence to Hidetaka Arimura.

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Nguyen, T.T.T., Arimura, H., Asamura, R. et al. Comparison of volumetric-modulated arc therapy and intensity-modulated radiation therapy prostate cancer plans accounting for cold spots. Radiol Phys Technol 12, 137–148 (2019). https://doi.org/10.1007/s12194-019-00502-0

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