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Dosimetric comparison of a 6-MV flattening-filter and a flattening-filter-free beam for lung stereotactic ablative radiotherapy treatment

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Abstract

The purpose of this study was to test the feasibility of clinical usage of a flattening-filter-free (FFF) beam for treatment with lung stereotactic ablative radiotherapy (SABR). Ten patients were treated with SABR and a 6-MV FFF beam for this study. All plans using volumetric modulated arc therapy (VMAT) were optimized in the Eclipse treatment planning system (TPS) by using the Acuros XB (AXB) dose calculation algorithm and were delivered by using a Varian TrueBeam™ linear accelerator equipped with a high-definition (HD) multi-leaf collimator. The prescription dose used was 48 Gy in 4 fractions. In order to compare the plan using a conventional 6-MV flattening-filter (FF) beam, the SABR plan was recalculated under the condition of the same beam settings used in the plan employing the 6-MV FFF beam. All dose distributions were calculated by using Acuros XB (AXB, version 11) and a 2.5-mm isotropic dose grid. The cumulative dosevolume histograms (DVH) for the planning target volume (PTV) and all organs at risk (OARs) were analyzed. Technical parameters, such as total monitor units (MUs) and the delivery time, were also recorded and assessed. All plans for target volumes met the planning objectives for the PTV (i.e., V95% > 95%) and the maximum dose (i.e., Dmax < 110%) revealing adequate target coverage for the 6-MV FF and FFF beams. Differences in DVH for target volumes (PTV and clinical target volume (CTV)) and OARs on the lung SABR plans from the interchange of the treatment beams were small, but showed a marked reduction (52.97%) in the treatment delivery time. The SABR plan with a FFF beam required a larger number of MUs than the plan with the FF beam, and the mean difference in MUs was 4.65%. This study demonstrated that the use of the FFF beam for lung SABR plan provided better treatment efficiency relative to 6-MV FF beam. This strategy should be particularly beneficial for high dose conformity to the lung and decreased intra-fraction movements because of the shorter treatment delivery time. Future studies are necessary to assess the clinical outcome and the toxicity.

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Authors and Affiliations

  1. Department of Radiologic Technology, Choonhae College of Health Sciences, Ulsan, 44965, Korea

    Yon-Lae Kim

  2. Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, 13620, Korea

    Jin-Beom Chung & Jae-Sung Kim

  3. Department of Radiation Oncology, Konkuk University Medical Center, Seoul, 05030, Korea

    Jeong-Woo Lee

  4. Department of Radiation Oncology, Haeundae Paik Hospital, Inje University, Busan, 48108, Korea

    Jin-Young Kim

  5. Department of Biomedical Engineering, The Catholic University of Korea, Seoul, 06591, Korea

    Sang-Won Kang & Tae-Suk Suh

Authors
  1. Yon-Lae Kim
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  2. Jin-Beom Chung
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  3. Jae-Sung Kim
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  4. Jeong-Woo Lee
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  5. Jin-Young Kim
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Correspondence to Jin-Beom Chung or Tae-Suk Suh.

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Kim, YL., Chung, JB., Kim, JS. et al. Dosimetric comparison of a 6-MV flattening-filter and a flattening-filter-free beam for lung stereotactic ablative radiotherapy treatment. Journal of the Korean Physical Society 67, 1672–1678 (2015). https://doi.org/10.3938/jkps.67.1672

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  • DOI: https://doi.org/10.3938/jkps.67.1672

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