COMPARISON OF 3D CONFORMAL AND VOLUMETRIC MODULATED ARC TECH ACCORDING TO RTOG 0915 PROTOCOL TREATMENT PLANNING GUIDELINES IN STEREOTACTIC LUNG RADIATION THERAPHY
Abstract
In this study, 20 non-small cell lung cancer patients were treated according to the accepted physical criteria of the latest lung SBRT protocol RTOG 0915. VMAT, 3D conformal arc techniques with 6 MV FF and FFF energy modalities were used for treatment planning. VMAT technique has statistical significance and has shown better high dose and intermediate spillage region according to RTOG 0915 definitions; ratio of prescription isodose volume to the PTV volume Conformity index - CI , ratio of 50% prescription isodose volume to the PTV intermediate spillage volume - ISV , maximum dose in % of dose prescribed at 2 cm from PTV intermediate dose spillage location - ISL compared to 3DCA. Investigation of FFF and FF energy modalities demonstrate that FFF plans have advantages in RTOG 0915 criteria over FF plans. Results of all the plans point to VMAT-FFF as the optimal technique for lung SBRT treatments due to the high quality SBRT plans obtained
References
- Benedict, et al. Stereotactic body radiation therapy: The report of TG101. Med Phys 2010;37:4078–101.
- Timmerman RD, Bizekis CS, Pass HI, et al. Local surgical, ablative and radiation treatment of metastases. CA Cancer J Clin 2009;59:145–70. doi: 10.3322/caac.20013
- Rowell NP, Williams CJ. Radical radiotherapy for stage I/II non small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable): a systematic review. Thorax 2001;56:628–38.
- Nagata Y, Takayama K, Matsuo Y, et al. Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys 2005;63:1427–31. doi: 10.1016/j.ijrobp.2005.05.034
- Lax I, Blomgren H, Naslund I, Svanström R. Stereotactic radiotherapy of malignancies in the abdomen: Methodological aspects. Acta Oncol 1994;33:677–83.
- Blomgren H, Lax I, Naslund I, Svanström R. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator. Clinical experience of the first thirty-one patients. Acta Oncol 1995;34:861–70.
- Baumann P, Nyman J, Hoyer M, et al. Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol 2009;27:3290–6. doi: 10.1200/JCO.2008.21.5681
- Timmerman R, Paulus R, Galvin J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 2010;303:1070– 6. doi: 10.1001/jama.2010.261
- Budgell G, Brown K, Cashmore J, et al. IPEM topical report 1: guidance on implementing flattening filter free (FFF) radiotherapy. Phys Med Biol 2016;61(23):8360–94. doi: 10.1088/0031-9155/61/23/8360
- Fogliata A, Nicolini G, Clivio A, Vanetti E, Cozzi L. Dosimetric evaluation of Acuros XB Advanced Dose Calculation algorithm in heterogeneous media. Radiat Oncol 2011;6:82. doi: 10.1186/1748-717X-6-82
- Rana S, Rogers K, Pokharel S, Cheng C. Evaluation of Acuros XB algorithm based on RTOG 0813 dosimetric criteria for SBRT lung treatment with RapidArc. J Appl Clin Med Phys 2014;15:4474. doi: 10.1120/jacmp.v15i1.4474
- http://www.varianlignedevie.com/wp-content/uploads/2012/09/ Acuros-XB-Clinical-Perspectives-10156.pdf 08.2014
- Ong CL, Cuijpers JP, Senan S, Slotman BJ, Wilko FAR Verbakel. Impact of the calculation resolution of AAA for small fields and RapidArc treatment plans. Medical Physics 2011;38:4471–9. doi: 10.1118/1.3605468
- http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails. aspx?study=0915
- Ong CL, Verbakel WF, Cuijpers JP, Slotman BJ, Lagerwaard FJ, Senan S. Stereotactic radiotherapy for peripheral lung tumors: a comparison of volumetric modulated arc therapy with 3 other delivery techniques. Radiother Oncol 2010;97:437–42. doi: 10.1016/j. radonc.2010.09.027
- Dalaryd M, Kragl G, Ceberg C, et al. A Monte Carlo study of a flattening filter-free linear accelerator verified with measurements. Phys Med Biol 2011;55:7333–44. doi: 10.1088/0031-9155/55/23/010
- Zhang GG, Ku L, Dilling TJ, et al. Volumetric modulated arc planning for lung stereotactic body radiotheraphy using conventional and unflattened photon beams: a dosimetric comparison with 3D technique. Radiat Oncol 2011;6:152. doi: 10.1186/1748-717X-6-152
- Maidment BW 3rd, Geesey C, Xie C, Chinault J, Best R, Larner JM, Wijesooriya K. Dosimetric Comparison of VMAT-Based Lung SBRT Treatments With and Without a Flattening Filter: An Interinstitutional Study. Radiat Oncol 2014;90:S662. doi: 10.1016/j.ijrobp.2014.05.1953
- Hrbacek J, Lang S, Graydon SN, Klöck S, Riesterer O. Dosimetric comparison of flattened and unflattened beams for stereotactic ablative radiotherapy of stage I non-small cell lung cancer. Med Phys 2014;41:031709. doi: 10.1118/1.4866231
Akciğer Kanseri SBRT Uygulamalarının RTOG 0915 Protokolüne Uygun Doz Sınırlamalarına Göre Oluşturulan 3B Konformal Ark ve VMAT SBRT Planlarının Karşılaştırılması
Abstract
Bu çalışmada 20 erken evre küçük hücreli dışı akciğer kanseri hastasının KHDAK , akciğer stereotactic body radiation therapy SBRT için en son olarak yayımlanan Radiation Therapy Oncology Group 0915 RTOG 0915 protokolünün fiziksel kabul kriterlerine göre tedavi planlamaları yapılmıştır. Planlamalar, volumetric modulated arc therapy VMAT ve 3B konformal ark teknikleri kullanarak 6MV düzleştirici filtreli FF ve 6MV düzleştirici filtresiz FFF enerji modlarında yapılmıştır. VMAT tekniği 3B konformal ark tekniği ile kıyaslandığında RTOG 0915 protokolünün yüksek ve orta doz saçılım kriterleri olan konformite indeksi CI , orta doz saçılmalarını ifade eden %50 izodoz hacminin planning target volume PTV hacmine oranı, 2 cm uzaktaki % doz değeri göre istatistiksel olarak anlamlı sonuçlar ile birlikte daha iyi planlar ortaya koymuştur. Enerji modaliteleri kendi aralarında incelendiğinde FFF modu ile yapılan planlar FF modu ile yapılan planlara göre RTOG 0915 kriterleri bakımından daha avantajlı sonuçlar vermişlerdir. Çalışmanın bütünü ele alındığında VMAT-FFF tekniği, yüksek ve orta doz saçılmalarındaki avantajlarına bağlı olarak akciğer SBRT tedavileri için en uygun teknik olarak bulunmuştur.
References
- Benedict, et al. Stereotactic body radiation therapy: The report of TG101. Med Phys 2010;37:4078–101.
- Timmerman RD, Bizekis CS, Pass HI, et al. Local surgical, ablative and radiation treatment of metastases. CA Cancer J Clin 2009;59:145–70. doi: 10.3322/caac.20013
- Rowell NP, Williams CJ. Radical radiotherapy for stage I/II non small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable): a systematic review. Thorax 2001;56:628–38.
- Nagata Y, Takayama K, Matsuo Y, et al. Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys 2005;63:1427–31. doi: 10.1016/j.ijrobp.2005.05.034
- Lax I, Blomgren H, Naslund I, Svanström R. Stereotactic radiotherapy of malignancies in the abdomen: Methodological aspects. Acta Oncol 1994;33:677–83.
- Blomgren H, Lax I, Naslund I, Svanström R. Stereotactic high dose fraction radiation therapy of extracranial tumors using an accelerator. Clinical experience of the first thirty-one patients. Acta Oncol 1995;34:861–70.
- Baumann P, Nyman J, Hoyer M, et al. Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy. J Clin Oncol 2009;27:3290–6. doi: 10.1200/JCO.2008.21.5681
- Timmerman R, Paulus R, Galvin J, et al. Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 2010;303:1070– 6. doi: 10.1001/jama.2010.261
- Budgell G, Brown K, Cashmore J, et al. IPEM topical report 1: guidance on implementing flattening filter free (FFF) radiotherapy. Phys Med Biol 2016;61(23):8360–94. doi: 10.1088/0031-9155/61/23/8360
- Fogliata A, Nicolini G, Clivio A, Vanetti E, Cozzi L. Dosimetric evaluation of Acuros XB Advanced Dose Calculation algorithm in heterogeneous media. Radiat Oncol 2011;6:82. doi: 10.1186/1748-717X-6-82
- Rana S, Rogers K, Pokharel S, Cheng C. Evaluation of Acuros XB algorithm based on RTOG 0813 dosimetric criteria for SBRT lung treatment with RapidArc. J Appl Clin Med Phys 2014;15:4474. doi: 10.1120/jacmp.v15i1.4474
- http://www.varianlignedevie.com/wp-content/uploads/2012/09/ Acuros-XB-Clinical-Perspectives-10156.pdf 08.2014
- Ong CL, Cuijpers JP, Senan S, Slotman BJ, Wilko FAR Verbakel. Impact of the calculation resolution of AAA for small fields and RapidArc treatment plans. Medical Physics 2011;38:4471–9. doi: 10.1118/1.3605468
- http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails. aspx?study=0915
- Ong CL, Verbakel WF, Cuijpers JP, Slotman BJ, Lagerwaard FJ, Senan S. Stereotactic radiotherapy for peripheral lung tumors: a comparison of volumetric modulated arc therapy with 3 other delivery techniques. Radiother Oncol 2010;97:437–42. doi: 10.1016/j. radonc.2010.09.027
- Dalaryd M, Kragl G, Ceberg C, et al. A Monte Carlo study of a flattening filter-free linear accelerator verified with measurements. Phys Med Biol 2011;55:7333–44. doi: 10.1088/0031-9155/55/23/010
- Zhang GG, Ku L, Dilling TJ, et al. Volumetric modulated arc planning for lung stereotactic body radiotheraphy using conventional and unflattened photon beams: a dosimetric comparison with 3D technique. Radiat Oncol 2011;6:152. doi: 10.1186/1748-717X-6-152
- Maidment BW 3rd, Geesey C, Xie C, Chinault J, Best R, Larner JM, Wijesooriya K. Dosimetric Comparison of VMAT-Based Lung SBRT Treatments With and Without a Flattening Filter: An Interinstitutional Study. Radiat Oncol 2014;90:S662. doi: 10.1016/j.ijrobp.2014.05.1953
- Hrbacek J, Lang S, Graydon SN, Klöck S, Riesterer O. Dosimetric comparison of flattened and unflattened beams for stereotactic ablative radiotherapy of stage I non-small cell lung cancer. Med Phys 2014;41:031709. doi: 10.1118/1.4866231
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | September 1, 2017 |
| Published in Issue | Year 2017Issue: 3 |