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Optimal planning strategy among various arc arrangements for prostate stereotactic body radiotherapy with volumetric modulated arc therapy technique

Sang Won Kang

Sang Won Kang

  • Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of KoreaSeoul, Korea
  • Department of Biomedical Engineering, College of Medicine, The Catholic University of KoreaSeoul, Korea
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Kang, Sang Won
, 
Jin Beom Chung

Jin Beom Chung

Department of Radiation Oncology, Seoul National University Bundang HospitalSeongnam, Korea
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Chung, Jin Beom
, 
Jae Sung Kim

Jae Sung Kim

Department of Radiation Oncology, Seoul National University Bundang HospitalSeongnam, Korea
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Kim, Jae Sung
, 
In Ah Kim

In Ah Kim

Department of Radiation Oncology, Seoul National University Bundang HospitalSeongnam, Korea
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Kim, In Ah
, 
Keun Yong Eom

Keun Yong Eom

Department of Radiation Oncology, Seoul National University Bundang HospitalSeongnam, Korea
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Eom, Keun Yong
, 
Changhoon Song

Changhoon Song

Department of Radiation Oncology, Seoul National University Bundang HospitalSeongnam, Korea
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Song, Changhoon
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Jeong Woo Lee

Jeong Woo Lee

Department of Radiation Oncology, Konkuk University Medical centerSeoul, Korea
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Lee, Jeong Woo
, 
Jin Young Kim

Jin Young Kim

Department of Radiation Oncology, Haeundae Paik Hospital, Inje UniversityBusan, Korea
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Kim, Jin Young
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Tae Suk Suh

Tae Suk Suh

  • Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of KoreaSeoul, Korea
  • Department of Biomedical Engineering, College of Medicine, The Catholic University of KoreaSeoul, Korea
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Suh, Tae Suk
  
15 gen 2017
Optimal planning strategy among various arc arrangements for prostate stereotactic body radiotherapy with volumetric modulated arc therapy technique's Cover Image
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Categoria dell'articolo: Research Article
Pubblicato online: 15 gen 2017
Pagine: 112 - 120
Ricevuto: 19 lug 2016
Accettato: 25 ott 2016
DOI: https://doi.org/10.1515/raon-2017-0005
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© 2017 Sang Won Kang, Jin Beom Chung, Jae Sung Kim, In Ah Kim, Keun Yong Eom, Changhoon Song, Jeong Woo Lee, Jin Young Kim, Tae Suk Suh
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
An arrangement of (A) one full arc (1FA), (B) one partial arc (1PA), (C) two full arcs (2FA), and (D) two partial arcs (2PA) in prostate SBRT-VMAT for the same patient.
An arrangement of (A) one full arc (1FA), (B) one partial arc (1PA), (C) two full arcs (2FA), and (D) two partial arcs (2PA) in prostate SBRT-VMAT for the same patient.
An example of the dose distributions achieved with (A) one full arc (1FA), (B) one partial arc (1PA), (C) two full arcs (2FA), and (D) two partial arcs (2PA) arrangement in prostate SBRT-VMAT for the same patient.
An example of the dose distributions achieved with (A) one full arc (1FA), (B) one partial arc (1PA), (C) two full arcs (2FA), and (D) two partial arcs (2PA) arrangement in prostate SBRT-VMAT for the same patient.
Average dose-volume histograms of the (A) PTV, (B) bladder, (C) rectum, (D) left femoral head, and (E) right femoral head from prostate SBRT-VMAT plans for four arc arrangements (1FA, 1PA, 2FA, and 2PA).
Average dose-volume histograms of the (A) PTV, (B) bladder, (C) rectum, (D) left femoral head, and (E) right femoral head from prostate SBRT-VMAT plans for four arc arrangements (1FA, 1PA, 2FA, and 2PA).

Dosimetric results for target volumes in prostate SABR-VMAT plans using four arc arrangements_

Avg ±SD (range)
1FA1PA2FA2PA
CTV coverage
 D50% (Gy)44.9±0.444.6±0.544.5±0.544.4±0.3
(44.4-45.4)(44.1-45.1)(44.0-45.3)(44.0-44.7)
 D5% (Gy)46.0±0.145.9±0.145.9±0.145.8±0.2
(45.9-46.1)(45.7-46.0)(45.8-46.0)(45.7-45.9)
 D95% (Gy)43.5±0.543.1±0.443.1±0.642.8±0.2
(43.0-44.2)(42.8-43.5)(42.6-43.9)(42.7-43.1)
 V100% (%)98.4±1.897.9±0.097.8±3.897.6±2.0
(95.5-100.0)(95.0-99.8)(95.2-100.0)(94.2-99.9)
PTV coverage
 Dmean44.3±0.244.2±0.144.1±0.344.3±0.1
(44.2-44.6)(44.0-44.4)(44.0-44.6)(44.2-44.5)
 Dmax48.8±0.849.5±0.948.5±1.149.0±1.4
(47.8-49.8)(48.4-50.5)(47.2-50.0)(47.4-50.5)
 Dmin33.0±0.432.3±0.032.8±0.833.7±0.3
(32.4-33.2)(31.9-33.7)(32.1-33.9)(33.4-34.1)
 D50% (Gy)44.6±0.344.5±0.244.4±0.444.5±0.2
(44.2-45.0)(44.3-44.8)(44.1-45.0)(44.3-44.8)
 D5% (Gy)46.1±0.246.1±0.146.1±0.246.0±0.1
(45.9-46.3)(45.9-46.2)(45.9-46.3)(45.9-46.2)
 D95% (Gy)41.5±0.341.4±0.241.3±0.341.7±0.1
(41.1-41.8)(41.2-41.8)(41.0-41.7)(41.6-41.9)
 V100% (%)87.5±1.986.6±1.287.7±1.588.1±1.0
(85.1-90.2)(85.0-87.8)(85.8-89.3)(87.1-89.9)
 Conformity1.05±0.001.04±0.011.03±0.011.05±0.01
 index(1.02-1.03)(1.02-1.04)(1.02-1.04)(1.02-1.03)
 Conformation0.91±0.010.91±0.010.91±0.010.91±0.01
 number(0.90-0.92)(0.09-0.92)(0.91-0.92)(0.90-0.93)
 Homogeneity0.10±0.010.11±0.000.11±0.010.10±0.00
 index(0.09-0.12)(0.10-0.11)(0.10-0.12)(0.09-0.10)

Dose volume constraints adopted for planning study_

VolumeRectumBladderFemoral heads
V42.7Gy (100%) < 5%V42.7Gy(100%) < 10%V29.9Gy (70%) < 50%
V38.4Gy (90%) < 15%V34.7Gy (81%) < 25%Dmax <29.9 Gy
ConstraintsV32.0Gy (75%) < 35%V29.9 Gy(70%) < 50%
V28.0Gy (65%) < 45%
V24.8Gy (58%) < 70%
V20.0Gy (47%) < 80%

Average monitor unit and delivery time for prostate SBRT-VMAT plans using four arc arrangements_

Beams1FA (Mean ± SD)1PA (Mean ± SD)2FA (Mean ± SD)2PA (Mean ± SD)
MU1575±631627±561646±971660±98
Delivery time (min)1.01±0.020.69±0.012.00±0.011.36±0.02

TCP of prostate tumor and NTCP of OARs for four arc arrangement plans_

Beams1FA (Mean±SD)1PA (Mean±SD)2FA (Mean±SD)2PA (Mean±SD)
TCP (%)
 Prostate93.35±0.0899.28±0.0693.32±0.0893.36±0.08
NTCP (%)
 Rectum0.44±0.230.61±0.210.40±0.230.56±0.22
 Bladder0.01±0.020.01±0.030.00±0.010.00±0.02
 LT Femur0.00±0.000.00±0.000.00±0.000.00±0.00
 RT Femur0.00±0.000.00±0.000.00±0.000.00±0.00

Parameters used to calculated Niemierko’s EUD-based TCP and NTCP_

Tissue100%dpf (Gy)Fraction (#)αγ50TD50 (Gy)TCD50 (Gy)dpf (Gy)α/β (Gy)
Prostate6.17-101.028.3421.20
Rectum6.178.3348023.90
Bladder6.17248028.00
Femur6.17446520.85

Dosimetric results for organs at risk in prostate SABR-VMAT plans using four arc arrangements_

Avg SD (range)
IFA1PA2FA2PA
Organs at risk
Rectum Dmean (Gy)25.2±1.723.3±2.023.6±1.823.4±1.9
(23.1-27.2)(21.4-25.8)(21.3-26.0)(21.3-26.4)
Rectum D2% (Gy)44.2±0.344.6±0.444.1±0.444.5±0.2
(43.7-44.5)(44.0-45.1)(43.8-44.7)(44.3-44.9)
Rectum V95% (%)9.0±1.410.1±1.38.3±1.39.8±1.5
(6.6-10.3)(8.1-11.5)(7.0-10.2)(7.6-11.6)
Rectum V80% (%)19.1±3.019.7±3.218.0±2.819.4±3.4
(15.1-23.2)(15.2-23.8)(15.2-21.9)(14.8-24.3)
Rectum V50% (%)71.0±8.853.9±9.460.0±11.154.1±9.0
(61.1-80.1)(41.9-63.7)(46.9-77.4)(42.5-66.7)
Rectum V20% (%)90.2±2.590.0±2.789.6±3.090.0±2.8
(87.7-93.4)(87.1-94.1)(85.6-93.5)(87.3-94.0)
Bladder Dmean (Gy)19.0±6.918.7±7.118.5±6.118.3±6.9
(13.4-31.1)(13.2-31.0)(15.7-29.0)(12.9-30.4)
Bladder D2% (Gy)45.6±0.245.6±0.245.5±0.345.6±0.4
(45.5-45.8)(45.3-45.9)(45.0-45.8)(45.3-46.4)
Bladder V95% (%)21.2±11.121.4±11.120.9±10.521.4±11.3
(10.5-39.3)(10.6-39.4)(10.3-37.7)(10.7-39.9)
Bladder V80% (%)25.6±11.926.2±11.925.7±11.126.0±12.0
(16.6-46.4)(16.5-46.3)(16.6-44.6)(16.3-46.2)
Bladder V50% (%)40.4±13.638.6±12.639.5±12.438.2±12.9
(29.4-64.1)(28.5-60.5)(29.2-60.7)(27.5-60.6)
Bladder V20% (%)54.4±17.052.5±16.154.1±17.452.1±16.1
(37.2-79.1)(36.4-76.5)(37.0-79.4)(36.2-76.1)
Left femoral head12.8±1.818.7±2.312.7±2.413.9±1.4
Dmean (Gy)(10.5-15.1)(16.9-22.7)(9.3-14.9)(11.7-15.3)
Left femoral head19.7±2.223.5±4.418.3±3.020.1±2.0
D2% (Gy)(16.9-21.8)(15.6-26.1)(13.4-20.7)(16.7-21.8)
Right femoral10.8±0.913.3±2.512.4±1.713.7±2.1
head Dmean (Gy)(9.2-11.3)(9.2-15.5)(10.5-14.2)(10.7-16.5)
Right femoral16.4±1.320.6±3.718.1±1.919.7±2.3
head D2% (Gy)(14.3-18.0)(14.3-23.6)(15.8-20.1)(16.2-22.5)
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Inglese
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Medicina, Medicina clinica, Medicina interna, Ematologia, Oncologia, Radiologia
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