Feasibility and potential advantages using VMAT in SRS metastasis treatments
| Autor: | Antonio Vicente Menendez, Carlos Botella, M.J. Pérez-Calatayud, Antonio J. Conde-Moreno, Mariola Bernisz, Francisco Javier Celada-Alvarez, Vicente Carmona, Françoise Lliso, Jose Perez-Calatayud, J. Gimeno-Olmos |
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| Rok vydání: | 2021 |
| Předmět: |
business.industry
medicine.medical_treatment Normal tissue medicine.disease Volumetric modulated arc therapy Radiosurgery 030218 nuclear medicine & medical imaging Metastasis Radiation therapy 03 medical and health sciences 0302 clinical medicine Oncology Internal dose 030220 oncology & carcinogenesis medicine Dose escalation Radiology Nuclear Medicine and imaging business Nuclear medicine Whole brain radiation therapy Research Paper |
| Zdroj: | Rep Pract Oncol Radiother |
| ISSN: | 2083-4640 1507-1367 |
| Popis: | Background: Utilization of stereotactic radiosurgery (SRS) for brain metastases (BM) has become the technique of choice as opposed to whole brain radiation therapy (WBRT). The aim of this work is to evaluate the feasibility and potential benefits in terms of normal tissue (NT) and dose escalation of volumetric modulated arc therapy (VMAT) in SRS metastasis treatment. A VMAT optimization procedure has therefore been developed for internal dose scaling which minimizes planner dependence. Materials and methods: Five patient-plans incorporating treatment with frame-based SRS with dynamic conformal arc technique (DA) were re-planned for VMAT. The lesions selected were between 4–6 cm 3 . The same geometry used in the DA plans was maintained for the VMAT cases. A VMAT planning procedure was performed attempting to scale the dose in inner auxiliary volumes, and to explore the potential for dose scaling with this technique. Comparison of dose-volume histogram (DVH) parameters were obtained. Results: VMAT allows a superior NT sparing plus conformity and dose scaling using the auxiliary volumes. The VMAT results were significantly superior in NT sparing, improving both the V 10 and V 12 values in all cases, with a 2–3 cm 3 saving. In addition, VMAT improves the dose coverage D 95 by about 0.5 Gy. The objective of dose escalation was achieved with VMAT with an increment of the Dmean and the Dmedian of about 2 Gy. Conclusions: This work shows a benefit of VMAT in SRS treatment with significant NT sparing. A VMAT optimization procedure, based on auxiliary inner volumes, has been developed, enabling internal dose escalation. |
| Databáze: | OpenAIRE |
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