Department of Radiation Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China , xiangzuolinmd@hotmail.com
Abstract: (1974 Views)
Background:To perform a comparison of the plan quality between volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) for multiple liver metastases using single-isocenter stereotactic body radiotherapy (SBRT).
Materials and Methods:Twenty-one patients who developed two or three adjacent liver metastases were included. For every patient, both VMAT and IMRT plans were replanned respectively for SBRT treatment. Dosimetric parameters, including the mean dose for the planning target volume, conformity index (CI), homogeneity index (HI) and gradient index (GI), were evaluated. Normal tissue sparing was also investigated. Finally, the total delivered monitor units (MUs) for both groups of treatment plans during irradiation were measured and compared. Results:Both groups of treatment plans satisfied normal tissue tolerance and produced clinically accepted dose distributions. The VMAT plans provided higher values of HI and GI as well as similar CI values in comparison with the IMRT plans. In addition, the VMAT plans obtained ultimately a improved mean dose to the target and a reduced dose to the organs at risk. However, there were no statistically significant differences in the V7Gy and D700cc of healthy liver, the mean dose and V15Gy of the ipsilateral kidney, the mean dose to the stomach, and the maximum dose to the heart between the two groups. Finally, the VMAT plans showed fewer MUs than the IMRT plans. Conclusions:The plan quality of single-isocenter VMAT plans is superior to that of IMRT plans for the SBRT treatment of multiple metastatic liver tumors from the perspective of pure physical parameters.
1. 1. Weiss L, Grundmann E, Torhorst J, Hartveit F, Moberg I, et al. (1986) Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. The Journal of Pathology, 150(3): 195-203. [DOI:10.1002/path.1711500308] [PMID]
3. House MG, Ito H, Gonen M, Fong Y, Allen PJ, DeMatteo RP, et al. (2010) Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. Journal of the American College of Surgeons, 210(5): 744-52, 52-5. [DOI:10.1016/j.jamcollsurg.2009.12.040] [PMID]
4. Robertson DJ, Stukel TA, Gottlieb DJ, Sutherland JM, Fisher ES (2009) Survival after hepatic resection of colorectal cancer metastases: a national experience. Cancer, 115(4): 752-9. [DOI:10.1002/cncr.24081] [PMID] []
5. Wei AC, Greig PD, Grant D, Taylor B, Langer B, Gallinger S (2006) Survival after hepatic resection for colorectal metastases: a 10-year experience. Annals of Surgical Oncology, 13(5):668-76. [DOI:10.1245/ASO.2006.05.039] [PMID]
6. Andratschke NH, Nieder C, Heppt F, Molls M, Zimmermann F (2015) Stereotactic radiation therapy for liver metastases: factors affecting local control and survival. Radiation Oncology, 10: 69. [DOI:10.1186/s13014-015-0369-9] [PMID] []
7. Clark GM, Popple RA, Young PE, Fiveash JB (2010) Feasibility of single-isocenter volumetric modulated arc radiosurgery for treatment of multiple brain metastases. Int J Radiat Oncol Biol Phys, 76(1): 296-302. [DOI:10.1016/j.ijrobp.2009.05.029] [PMID]
8. Quan K, Xu KM, Lalonde R, Horne ZD, Bernard ME, et al. (2015) Treatment plan technique and quality for single-isocenter stereotactic ablative radiotherapy of multiple lung lesions with volumetric-modulated arc therapy or intensity-modulated radiosurgery. Frontiers in Oncology, 5: 213. [DOI:10.3389/fonc.2015.00213] [PMID] []
9. Sanford L, Molloy J, Kumar S, Randall M, McGarry R, Pokhrel D (2019) Evaluation of plan quality and treatment efficiency for single-isocenter/two-lesion lung stereotactic body radiation therapy. J Appl Clin Med Phys, 20(1): 118-27. [DOI:10.1002/acm2.12500] [PMID] []
10. Haritha C, Shankar V, Bhaskar VN, Bhange A, Karuppusamy A (2018) Single-Isocenter Volumetric Modulated SBRT for Multiple Spinal Targets - Plan Quality and Challenges. Int J Radiat Oncol Biol Phys, 102: e511. [DOI:10.1016/j.ijrobp.2018.07.1446]
11. Amoush A, Murray E, Yu JS, Xia P (2015) Single-isocenter hybrid IMRT plans versus two-isocenter conventional plans and impact of intrafraction motion for the treatment of breast cancer with supraclavicular lymph nodes involvement. Journal of applied clinical medical physics, 16(4): 31-9--9. [DOI:10.1120/jacmp.v16i4.5188] [PMID] []
12. Raza GH, Capone L, Tini P, Giraffa M, Gentile P, Minniti G (2022) Single-isocenter multiple-target stereotactic radiosurgery for multiple brain metastases: dosimetric evaluation of two automated treatment planning systems. Radiation Oncology, 17(1): 116. [DOI:10.1186/s13014-022-02086-3] [PMID] []
13. van Timmeren JE, Ehrbar S, Chamberlain M, Mayinger M, Hoogeman MS, et al. (2022) Single-isocenter versus multiple-isocenters for multiple lung metastases: Evaluation of lung dose. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 166: 189-94. [DOI:10.1016/j.radonc.2021.11.030] [PMID]
14. Kavanagh BD, Schefter TE, Cardenes HR, Stieber VW, et al. (2006) Interim analysis of a prospective phase I/II trial of SBRT for liver metastases. Acta Oncologica, 45(7): 848-55. [DOI:10.1080/02841860600904870] [PMID]
15. Pan CC, Kavanagh BD, Dawson LA, Li XA, Das SK, Miften M, Ten Haken RK (2010) Radiation-associated liver injury. Int J Radiat Oncol Biol Phys, 76(3): S94-100. [DOI:10.1016/j.ijrobp.2009.06.092] [PMID] []
16. Rusthoven KE, Kavanagh BD, Cardenes H, Stieber VW, et al. (2009) Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 27(10): 1572-8. [DOI:10.1200/JCO.2008.19.6329] [PMID]
17. Paddick I (2000) A simple scoring ratio to index the conformity of radiosurgical treatment plans. Technical note. Journal of Neurosurgery, 93(3): 219-22. [DOI:10.3171/jns.2000.93.supplement_3.0219]
18. Wu Q, Mohan R, Morris M, Lauve A, Schmidt-Ullrich R (2003) Simultaneous integrated boost intensity-modulated radiotherapy for locally advanced head-and-neck squamous cell carcinomas. I: dosimetric results. Int J Radiat Oncol Biol Phys, 56(2): 573-85. [DOI:10.1016/S0360-3016(02)04617-5] [PMID]
19. Paddick I and Lippitz B (2006) A simple dose gradient measurement tool to complement the conformity index. Journal of Neurosurgery, 105: 194-201. [DOI:10.3171/sup.2006.105.7.194] [PMID]
20. Otto K (2008) Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys, 35(1): 310-7. [DOI:10.1118/1.2818738] [PMID]
21. Park JM, Kim K, Chie EK, Choi CH, Ye SJ, Ha SW (2012) RapidArc vs intensity-modulated radiation therapy for hepatocellular carcinoma: a comparative planning study. Br J Radiol, 85(1015): e323-e9. [DOI:10.1259/bjr/19088580] [PMID] []
22. Parikh NR, Kundu P, Levin-Epstein R, Chang EM, Agazaryan N, et al. (2020) Time-driven activity-based costing comparison of stereotactic radiosurgery to multiple brain lesions using single-isocenter versus multiple-isocenter technique. International journal of radiation oncology, biology, physics, 108(4): 999-1007. [DOI:10.1016/j.ijrobp.2020.06.035] [PMID]
23. Hansen CR, Crijns W, Hussein M, Rossi L, Gallego P, et al. (2020) Radiotherapy treatment planning study guidelines (RATING): A framework for setting up and reporting on scientific treatment planning studies. Radiotherapy and oncology, 153: 67-78. [DOI:10.1016/j.radonc.2020.09.033] [PMID]
24. Bota K, Lock M, Ahmad B, Fisher B, Yartsev S, Wong E, Gaede S (2014) Dosimetric Comparison of Volumetric Modulated Arc Therapy, Tomotherapy, and Intensity Modulated Radiation Therapy for Radiation Dose Escalation of Hepatic Malignancies. Int J Radiat Oncol Biol Phys, 90(1): S381-S2. [DOI:10.1016/j.ijrobp.2014.05.1226]
25. Xie K, Sun H, Gao L, Lin T, Sui J, Ni X (2019) A comparative study of identical VMAT about two adjacent targets with and without fixed-jaw technique. Radiation Oncology, 14(1): 75. [DOI:10.1186/s13014-019-1284-2] [PMID] []
26. Li Z, Zeng J, Wang Z, Zhu H, Wei Y (2014) Dosimetric comparison of intensity modulated and volumetric arc radiation therapy for gastric cancer. Oncology Letters, 8(4): 1427-34. [DOI:10.3892/ol.2014.2363] [PMID] []
27. Liu X, Huang E, Wang Y, He Y, Luo H, Zhong M, et al. (2017) Dosimetric comparison of helical tomotherapy, VMAT, fixed-field IMRT and 3D-conformal radiotherapy for stage I-II nasal natural killer T-cell lymphoma. Radiation Oncology, 12(1): 76. [DOI:10.1186/s13014-017-0812-1] [PMID] []
28. Tas B, Durmus IF, Uzel OE, Okumus A (2017) Conformity Index, Gradient Index, Heterogeneity Index, and Size of Metastasis Correlations for LINAC-Based Stereotactic Radiosurgery/Radiation Therapy. Int J Radiat Oncol Biol Phys, 99(2): E727. [DOI:10.1016/j.ijrobp.2017.06.2351]
29. Chen D, Wang R, Meng X, Liu T, Yan H, Feng R, et al. (2014) A comparison of liver protection among 3-D conformal radiotherapy, intensity-modulated radiotherapy and RapidArc for hepatocellular carcinoma. Radiation Oncology, 9: 48. [DOI:10.1186/1748-717X-9-48] [PMID] []
30. Ren W, Sun C, Lu N, Xu Y, Han F, Liu YP, Dai J (2016) Dosimetric comparison of intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy in patients with prostate cancer: a meta-analysis. J Appl Clin Med Phys, 17(6): 254-62. [DOI:10.1120/jacmp.v17i6.6464] [PMID] []
31. Kai Y, Toya R, Saito T, Kuraoka A, Shimohigashi Y, et al. (2018) Plan quality and delivery time comparisons between volumetric modulated arc therapy and intensity modulated radiation therapy for scalp angiosarcoma: A planning study. J Med Radiat Sci, 65(1): 39-47. [DOI:10.1002/jmrs.239] [PMID] []
32. Nithya L, Raj NAN, Kumar A, Rathinamuthu S, Pandey MB (2014) Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer. J Medical Physics, 39(2): 121-6. [DOI:10.4103/0971-6203.131288] [PMID] []
33. Bortfeld T, Jiang SB, Rietzel E (2004) Effects of motion on the total dose distribution. Seminars in Radiation Oncology, 14(1): 41-51. [DOI:10.1053/j.semradonc.2003.10.011] [PMID]
35. Chang J (2018) Incorporating the rotational setup uncertainty into the planning target volume margin expansion for the single isocenter for multiple targets technique. Practical Radiation Oncology, 8(6): 475-83. [DOI:10.1016/j.prro.2018.04.011] [PMID]
36. Bissonnette JP, Franks KN, Purdie TG, Moseley DJ, Sonke JJ, et al. (2009) Quantifying interfraction and intrafraction tumor motion in lung stereotactic body radiotherapy using respiration-correlated cone beam computed tomography. Int J Radiat Oncol Biol Phys, 75(3): 688-95. [DOI:10.1016/j.ijrobp.2008.11.066] [PMID]
Zhu L, Lu X, Wang A, Xiang Z. Comparison of VMAT and IMRT plans for SBRT treatment of multiple liver metastases using a single isocenter. Int J Radiat Res 2023; 21 (2) :189-194 URL: http://ijrr.com/article-1-4638-en.html