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VMAT treatment plan acceptability and quality assurance study for prostate cancer in radiotherapy

Published online by Cambridge University Press:  10 January 2020

Robina Sarwar ,
Saima Altaf Open the ORCID record for Saima Altaf [Opens in a new window] ,
Rao M. Afzal Khan ,
Saeed A. Buzdar  and
Khalid Iqbal
Robina Sarwar
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan
Saima Altaf*
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan Department of Physics, The Women University, Multan, Pakistan
Rao M. Afzal Khan
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan
Saeed A. Buzdar
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan
Khalid Iqbal
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan Department of Clinical & Radiation Oncology, Shaukat Khanum Cancer Hospital & Research Center, Lahore, Pakistan
*
Author of correspondence: Saima Altaf, Department of Physics, The Women University, Multan, Pakistan. Tel: +923000694166. E-mail: saima.6324@wum.edu.pk
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Abstract

Aim:

The aim of this work was to study the acceptability of plans prepared for prostate patients treated by volumetric modulated arc therapy (VMAT) with the vision to evaluate the quality of plans and test pre-treatment quality assurance (QA).

Material methods:

VMAT plans of 35 patients, planned on the Eclipse Treatment Planning System (Aria 15), were included in the study. Plan acceptability was checked using statistical analysis, which includes homogeneity index, radical and median homogeneity index, coverage and uniformity index. Dose–volume histograms (DVH) of the plans were also studied to check prescribed dose (PD), Dmax, Dmin, D5 and D95. Portal dosimetry was also done by gamma analysis using 3%/3 mm criterion. SD and mean SD error were also calculated and analysed.

Results:

Statistical analysis showed a mean HI of 1·054, coverage 0·959, UI 1·055, mDHI 0·962 and rDHI 0·866. SD of HI, coverage, UI, mDHI and rDHI was 0·019, 0·019, 0·014, 0·013 and 0·030, respectively. From the DVHs, mean of D5, D95, Dmin and Dmax was calculated at 6,252·9, 5,757·4, 6,413·3 and 5,657·7 cGy, respectively, with a prescribed dose of 6,000 cGy. According to gamma analysis, area gamma < 1 was 99·12% with a tolerance limit of 95%, maximum gamma was 1·466 with a tolerance limit of 3·5, average gamma was 0·388 with a tolerance limit of 0·5, area gamma > 1·2 was 0·242% with a tolerance limit of 0·5%, maximum dose difference was 0·6 with a tolerance limit of 1·0 and average dose difference was 0·029 with a tolerance limit of 0·2.

Conclusion:

All three computations showed the results to be within acceptable limits. VMAT possesses a unique feature of delivering the whole treatment with only two rotations of the gantry. VMAT has an improved efficiency of delivery for equivalent dosimetric quality.

Keywords

dose homogeneityEPIDgamma analysisVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 1 , March 2021 , pp. 43 - 48
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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