Palliation of Vertebral Metastases with Radiotherapy: Exploration of Volumetric-Modulated Arc Therapy From Development to Implementation in Routine Clinical Practice
| Autor: | Douglas Moseley, Michael Bhatti, Ahmar Abbas, Edwin Chan, Mojgan Taremi, Marlyn McIntosh, Z. Allibhai, Natalie Rozanec |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Planning target volume 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences 0302 clinical medicine Palliative radiotherapy medicine Humans Radiology Nuclear Medicine and imaging Routine clinical practice Conventional technique Aged Spinal Neoplasms Radiological and Ultrasound Technology business.industry Radiotherapy Planning Computer-Assisted Palliative Care Middle Aged Volumetric modulated arc therapy Radiation therapy 030220 oncology & carcinogenesis Female Radiology Radiotherapy Intensity-Modulated Spinal metastases business Homogeneity index |
| Zdroj: | Journal of medical imaging and radiation sciences. 50(1) |
| ISSN: | 1876-7982 |
| Popis: | The development of volumetric-modulated arc therapy (VMAT) in radiation therapy has allowed for improved dose escalation and a decrease in radiation-induced toxicities for patients. This article will describe a single centre's experience in development and implementation of VMAT for palliation of vertebral metastases. A retrospective planning analysis of 10 cases identified that utilization of VMAT decreases overall planning time with a statistically significant improvement in target coverage when compared with the current conventional technique. PTV Dmax (P = .02), PTV V9519Gy (95%) (P = .01), dose conformation (P = 1.8e-004), and the homogeneity index (P = .019) were all superior for VMAT plans with an average PTV length of 22.46 cm. Another benefit of VMAT utilization is a significant decrease in treatment delivery time, which reduced treatment times from 9.95 minutes to 2.98 minutes. Immobilization was also carefully considered, and rotational errors were measured and fell within institutional tolerances when VMAT was delivered using simple immobilization devices. Clinical implementation of this technique, utilizing a highly conformal target volume to decrease radiation-induced toxicities and minimizing the length of time patients are required to maintain their treatment positions, aims to improve the palliative radiotherapy experience for patients with painful spinal metastases. |
| Databáze: | OpenAIRE |
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