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Gemma Eminowicz, Vasilis Rompokos, Christopher Stacey, Lisa Hall, Mary McCormack
BACKGROUND: Advanced radiotherapy techniques reduce normal tissue dose by conforming closely to target volumes. In cervical cancer radiotherapy, organ filling affects clinical target volume (CTV; cervix, uterus) position. This study estimates the dosimetric effect of this primary CTV position variation during chemoradiation. METHODS/MATERIALS: Twice weekly cone-beam computed tomography (CBCT) images of ten patients undergoing cervical chemoradiation were retrospectively analysed...
November 16, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Anantharaman Ayyalusamy, Subramani Vellaiyan, Subramanian Shanmugam
OBJECTIVE: The purpose of the study is to use deformable mapping of planning CT electron density values on weekly cone beam computed tomography (CBCT) to quantify the anatomical changes and determine the dose volume relationship in offline adaptive volumetric modulated arc therapy. METHODS: Ten patients treated with RapidArc plans who had weekly CBCTs were selected retrospectively. Planning CT was deformed to weekly CBCTs and the deformed contours were checked for any discrepancies...
October 26, 2016: British Journal of Radiology
Suresh Rana, ChihYao Cheng, Li Zhao, SungYong Park, Gary Larson, Carlos Vargas, Megan Dunn, Yuanshui Zheng
INTRODUCTION: The purpose of this study was to evaluate the dosimetric and radiobiological impact of intensity modulated proton therapy (IMPT) and RapidArc planning for high-risk prostate cancer with seminal vesicles. METHODS: Ten high-risk prostate cancer cases were included in this retrospective study. For each case, IMPT plans were generated using multiple field optimisation (MFO) technique (two fields) with XiO treatment planning system (TPS), whereas RapidArc plans were generated using double-arc technique (two full arcs) with Eclipse TPS...
May 11, 2016: Journal of Medical Radiation Sciences
Ilma Xhaferllari, Omar El-Sherif, Stewart Gaede
Volumetric-modulated arc therapy (VMAT) is emerging as a leading technology in treating early-stage, non-small cell lung cancer (NSCLC) with stereotactic ablative radiotherapy (SABR). However, two other modalities capable of deliver-ing intensity-modulated radiation therapy (IMRT) include fixed-beam and helical TomoTherapy (HT). This study aims to provide an extensive dosimetric compari-son among these various IMRT techniques for treating early-stage NSCLC with SABR. Ten early-stage NSCLC patients were retrospectively optimized using three fixed-beam techniques via nine to eleven beams (high and low modulation step-and-shoot (SS), and sliding window (SW)), two VMAT techniques via two partial arcs (SmartArc (SA) and RapidArc (RA)), and three HT techniques via three different fan beam widths (1 cm, 2...
2016: Journal of Applied Clinical Medical Physics
Krishnappan Chockkalingam, Chandrasekaran Anu Radha, Vendhan Subramani, Vendhan Subramani, Madhan Kumar Gunasekaran
The purpose of this study is to evaluate the degree of dose distribution distortion in advanced treatments like IMRT and RapidArc when patient plans are swapped across dosimetrically equivalent so-called "beam-matched" machines. For this purpose the entire work is divided into two stages. At forefront stage all basic beam properties of 6 MV X-rays like PDD, profiles, output factors, TPR20/10 and MLC transmission of two beam-matched machines - Varian Clinac iX and Varian 600 C/D Unique - are compared and evaluated for differences...
2016: Journal of Applied Clinical Medical Physics
Scott R Silva, Murat Surucu, Jennifer Steber, Matthew M Harkenrider, Mehee Choi
OBJECTIVE: Radiation treatment planning for locally advanced lung cancer can be technically challenging, as delivery of ≥60 Gy to large volumes with concurrent chemotherapy is often associated with significant risk of normal tissue toxicity. We clinically implemented a novel hybrid RapidArc technique in patients with lung cancer and compared these plans with 3-dimensional conformal radiotherapy and RapidArc-only plans. MATERIALS/METHODS: Hybrid RapidArc was used to treat 11 patients with locally advanced lung cancer having bulky mediastinal adenopathy...
September 28, 2016: Technology in Cancer Research & Treatment
Mee Sun Yoon, Jae-Uk Jeong, Taek-Keun Nam, Sung-Ja Ahn, Woong-Ki Chung, Ju-Young Song
The dose of a real tumor target volume and surrounding organs at risk (OARs) under the effect of respiratory motion was calculated for a lung tumor plan, based on the target volume covering the whole tumor motion range for intensity modulated radiosurgery (IMRS). Two types of IMRS plans based on simulated respiratory motion were designed using humanoid and dynamic phantoms. Delivery quality assurance (DQA) was performed using ArcCHECK and MapCHECK2 for several moving conditions of the tumor and the real dose inside the humanoid phantom was evaluated using the 3DVH program...
2016: PloS One
Ganesh Narayanasamy, Sotirios Stathakis, Alonso N Gutierrez, Evangelos Pappas, Richard Crownover, John R Floyd, Niko Papanikolaou
BACKGROUND: In this treatment planning study, we compare the plan quality and delivery parameters for the treatment of multiple brain metastases using 2 monoisocentric techniques: the Multiple Metastases Element from Brainlab and the RapidArc volumetric-modulated arc therapy from Varian Medical Systems. METHODS: Eight patients who were treated in our institution for multiple metastases (3-7 lesions) were replanned with Multiple Metastases Element using noncoplanar dynamic conformal arcs...
September 9, 2016: Technology in Cancer Research & Treatment
Mohammad Hussein, Christopher P South, Miriam A Barry, Elizabeth J Adams, Tom J Jordan, Alexandra J Stewart, Andrew Nisbet
PURPOSE: The aim of this work was to determine whether a commercial knowledge-based treatment planning (KBP) module can efficiently produce IMRT and VMAT plans in the pelvic region (prostate & cervical cancer), and to assess sensitivity of plan quality to training data and model parameters. METHODS: Initial benchmarking of KBP was performed using prostate cancer cases. Structures and dose distributions from 40 patients previously treated using a 5-field IMRT technique were used for model training...
July 14, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Mariwan Baker, Claus F Behrens
BACKGROUND: In prostate radiotherapy, it is essential that the prostate position is within the planned volume during the treatment delivery. The aim of this study is to investigate whether intrafractional motion of the prostate is of clinical consequence, using a novel 4D autoscan ultrasound probe. METHODS: Ten prostate patients were ultrasound (US) scanned at the time of CT imaging and once a week during their course of radiotherapy treatment in an ethics-approved study, using the transperineal Clarity autoscan system (Clarity®, Elekta Inc...
2016: BMC Cancer
Ciro Franzese, Antonella Fogliata, Davide Franceschini, Elena Clerici, Giuseppe D'Agostino, Piera Navarria, Pietro Mancosu, Stefano Tomatis, Luca Cozzi, Marta Scorsetti
BACKGROUND/AIM: Radiotherapy is a common approach for treating squamous cell carcinoma (SCC) of the oropharynx. We aimed to analyze toxicity and outcome of patients affected by oropharyngeal SCC treated with volumetric modulated arc therapy (VMAT). PATIENTS AND METHODS: Fifty-four patients presenting advanced orophayngeal carcinoma who were treated with radical radiotherapy were analyzed. All patients were treated with VMAT-RapidArc, with simultaneous integrated boost in 33 fractions for a dose of 69...
July 2016: Anticancer Research
Jun Yuan, Mingjun Lei, Zhen Yang, Jun Fu, Lei Huo, Jidong Hong
The aim of the present study was to evaluate the difference in treatment plan quality, monitor units (MUs) per fraction and dosimetric parameters between IMRT (intensity-modulated radiotherapy) and RapidArc with single arc (RA1) and dual arc (RA2) for malignant glioma involving the parietal lobe. Treatment plans for IMRT and RA1 and RA2 were prepared for 10 patients with malignant gliomas involving the parietal lobe. The Wilcoxon matched-pair signed-rank test was used to compare the plan quality, monitor units and dosimetric parameters between IMRT and RA1 and RA2 through dose-volume histograms...
July 2016: Molecular and Clinical Oncology
A Scaggion, A Negri, M A Rossato, A Roggio, F Simonato, S Bacco, M Paiusco
PURPOSE: To establish the reliability and accuracy of a UNIQUE Linac in delivering RapidArc treatments and assess its long term stability. MATERIALS AND METHODS: UNIQUE performance was monitored and analyzed for a period of nearly two years. 2280 Dynalog files, related to 179 clinical RapidArc treatments were collected. Different tumor sites and dose scheduling were included, covering the full range of our treatment plans. Statistical distributions of MLC motion error, gantry rotation error and MU delivery error were evaluated...
July 2016: Physica Medica: PM
Jia-Yang Lu, Bao-Tian Huang, Lei Xing, Daniel T Chang, Xun Peng, Liang-Xi Xie, Zhi-Xiong Lin, Mei Li
This study aimed to investigate the dosimetric characteristics of an isocentrically shielded RapidArc (IS-RA) technique for treatment of locally recurrent nasopharyngeal cancer (lrNPC). In IS-RA, the isocenter was placed at the center of the pre-irradiated brainstem (BS)/spinal cord (SC) and the jaws were set to shield the BS/SC while ensuring the target coverage during the whole gantry rotation. For fifteen patients, the IS-RA plans were compared with the conventional RapidArc (C-RA) regarding target coverage, organ-at-risk (OAR) sparing and monitor units (MUs)...
2016: Scientific Reports
Gemma Eminowicz, Vasilis Rompokos, Christopher Stacey, Mary McCormack
BACKGROUND: Cervical cancer inter-observer delineation variation has been demonstrated. This article addresses its dosimetric impact. METHODS: 21 centres outlined two INTERLACE trial quality assurance test cases. A gold standard clinical target volume (GSCTV) was created from a consensus and STAPLE outline. RapidArc plans were created for all centres' planning target volumes (PTVs; PTV1+2). Gold standard PTVs (GSPTVs) were created for each plan by applying each centre's CTV-PTV margins to GSCTV...
May 6, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Cory Knill, Michael Snyder, Joseph T Rakowski, Ling Zhuang, Martha Matuszak, Jay Burmeister
PURPOSE: PTW's Octavius 1000 SRS array performs IMRT quality assurance (QA) measurements with liquid-filled ionization chambers (LICs) to allow closer detector spacing and higher resolution, compared to air-filled QA devices. However, reduced ion mobility in LICs relative to air leads to increased ion recombination effects and reduced collection efficiencies that are dependent on Linac pulse frequency and pulse dose. These pulse parameters are variable during an IMRT delivery, which affects QA results...
May 2016: Medical Physics
Lionel Perrier, Magali Morelle, Pascal Pommier, Pierre Boisselier, Bernard Coche-Dequeant, Olivier Gallocher, Marc Alfonsi, Etienne Bardet, Michel Rives, Valentin Calugaru, Enrique Chajon, Georges Noel, Hinda Mecellem, David Pérol, Sophie Dussart, Philippe Giraud
PURPOSE: This cost analysis aimed to prospectively assess differences in costs between TomoTherapy and volumetric modulated arc therapy (VMAT) in patients with head and neck cancer. METHODS AND MATERIALS: Economic data were gathered from a multicenter study. However, randomization was not possible due to the availability of equipment. Costs were calculated using the microcosting technique from the hospital's perspective (in 2013 euros), and the time horizon was radiation therapy...
June 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Fanny Martin, Florian Magnier, Lucie Berger, Jessica Miroir, Emmanuel Chautard, Pierre Verrelle, Michel Lapeyre, Julian Biau
BACKGROUND: Benign tumors of the skull base are a challenge when delivering radiotherapy. An appropriate choice of radiation technique may significantly improve the patient's outcomes. Our study aimed to compare the dosimetric results of fractionated stereotactic radiotherapy between non-coplanar dynamic arcs and coplanar volumetric modulated arctherapy (Rapidarc®). METHODS: Thirteen patients treated with Novalis TX® were analysed: six vestibular schwannomas, four pituitary adenomas and three meningioma...
2016: Radiation Oncology
Youqun Lai, Yanyan Chen, Sangang Wu, Liwan Shi, Lirong Fu, Huiming Ha, Qin Lin
Conventional volumetric modulated arc therapy (C-VMAT) for breast cancer after radical mastectomy had its limitation that resulted in larger volumes of normal tissue receiving low doses. We explored whether there was a way to deal with this disadvantage and determined the potential benefit of flattening filter-free (FFF) beams.Twenty patients with breast cancer after radical mastectomy were subjected to 3D conformal radiotherapy (3DCRT) and VMAT treatment planning. For VMAT plans, 3 different designs were employed with RapidArc form: conventional-VMAT plan (C-VMAT), modified-VMAT plan (M-VMAT), and modified-VMAT plan using FFF beams (M-VMAT-F)...
April 2016: Medicine (Baltimore)
Andreas Springer, Josef Hammer, Erwin Winkler, Christine Track, Roswitha Huppert, Alexandra Böhm, Hedwig Kasparu, Ansgar Weltermann, Gregor Aschauer, Andreas L Petzer, Ernst Putz, Alexander Altenburger, Rainer Gruber, Karin Moser, Karin Wiesauer, Hans Geinitz
BACKGROUND: To implement total body irradiation (TBI) using volumetric modulated arc therapy (VMAT). We applied the Varian RapidArc™ software to calculate and optimize the dose distribution. Emphasis was placed on applying a homogenous dose to the PTV and on reducing the dose to the lungs. METHODS: From July 2013 to July 2014 seven patients with leukaemia were planned and treated with a VMAT-based TBI-technique with photon energy of 6 MV. The overall planning target volume (PTV), comprising the whole body, had to be split into 8 segments with a subsequent multi-isocentric planning...
2016: Radiation Oncology
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