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Dosimetric comparison of volumetric modulated arc therapy and intensity modulated radiation therapy for anal cancer

Published online by Cambridge University Press:  01 July 2019

Bing-Hao Chiang ,
Kerry Hibbitts ,
Heather Ortega ,
Terence Herman  and
Salahuddin Ahmad
Bing-Hao Chiang
Affiliation:
Department of Radiation Oncology, Peggy & Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
Kerry Hibbitts
Affiliation:
Department of Radiation Oncology, Peggy & Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
Heather Ortega
Affiliation:
Department of Radiation Oncology, Peggy & Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
Terence Herman
Affiliation:
Department of Radiation Oncology, Peggy & Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
Salahuddin Ahmad*
Affiliation:
Department of Radiation Oncology, Peggy & Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
*
Author for correspondence: Salahuddin Ahmad, 800 NE 10th St, SCC L100, Oklahoma City, OK 73104. Tel: (405) 271-3016. E-mail: Salahuddin-ahmad@ouhsc.edu
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Abstract

Aim:

Volumetric modulated arc therapy (VMAT), an extension of intensity modulated radiation therapy (IMRT), employs modifications in gantry rotation speed, machine dose rate and multi-leaf collimator motion to deliver a three-dimensional dose distribution. This study compared VMAT to IMRT for patients with anal carcinoma.

Materials and Methods:

Sixteen patients previously treated with IMRT were retrospectively selected. Each patient received a total dose of 57·6–63·0 Gy in 1·8 Gy fractions. A single- or double-isocenter multi-arc VMAT treatment plan was generated using Eclipse RapidArc system with the same computed tomography image sets and optimisation constraints used for IMRT. Dose–volume histograms (DVHs) for planning target volumes (PTVs) and organs at risk (OARs), and monitor units (MUs) and beam on times (BOTs) were used for comparison.

Results:

IMRT and VMAT plans showed insignificant differences in PTV homogeneity and conformity and sparing hips and bowel. VMAT required fewer mean MU and shorter BOT per plan (1,597 MU, 2·66 min) compared to IMRT (2,571 MU, 4·29 min) with p < 0·0001.

Conclusions:

Fewer MU and shorter BOT for VMAT may decrease the damage from secondary radiation and treatment delivery uncertainty due to intra-fraction tumour motion, leading to higher machine throughput and improving patient comfort, with less treatment time.

Keywords

anal carcinomaIMRTtreatment timeVMAT
Type
Technical Note
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 2 , June 2020 , pp. 190 - 192
Copyright
© Cambridge University Press 2019

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