Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T12:19:08.241Z Has data issue: false hasContentIssue false
  • English
  • Français

An institutional review: dosimetry comparison between simultaneous integrated boost IMRT and VMAT for prostate cancer

Published online by Cambridge University Press:  09 June 2020

Raheel Mukhtar Open the ORCID record for Raheel Mukhtar [Opens in a new window] ,
Sumera Butt ,
Muhammad Abdur Rafaye ,
Khalid Iqbal ,
Sana Mazhar  and
Tabinda Sadaf
Raheel Mukhtar
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Sumera Butt
Affiliation:
Clinical and Radiation Oncology Department, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Muhammad Abdur Rafaye
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Khalid Iqbal*
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Sana Mazhar
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Tabinda Sadaf
Affiliation:
Clinical and Radiation Oncology Department, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
*
Author for correspondence: Khalid Iqbal, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A BLOCK R-3 MA, Johar Town Lahore, Lahore, Punjab54000, Pakistan. Tel: +00923006333815. E-mail: kiqbal@skm.org.pk
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose:

A comparative study was performed about the plan parameters and quality indices between volumetric arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for the treatment of high-risk prostate cancer patients. The aim of this retrospective study was to compare the two methods of external beam radiotherapy IMRT and VMAT in terms of plan quality and efficacy.

Material and method:

Fifteen high-risk prostate patients were planned for radiotherapy using 6 MV photon. Three dose levels were contoured having Planning Tumour Volume 1 (PTV1 = 48 Gy), Planning Tumour Volume 2 (PTV2 = 57.6 Gy) and Planning Tumour Volume 3 (PTV3 = 60 Gy). Setup margins were given using the CHIP trial method. The prescribed PTV3 dose was 60 Gy in 20 fractions which is biologically equivalent to 74 Gy in 37 fractions using α/β = 3. In case of IMRT, seven fixed beam angles 30, 60, 105, 180, 255, 300 and 330 were used and the dose was optimised using the sliding window method. In case of rapid arc technique, one or two full arcs were used for dose optimisation while keeping all the dose constraints and other planning parameters same used in IMRT. The plan evaluation parameters and Organ at risks (OARs) doses were calculated using a dose volume histogram (DVH).

Results:

The average D2, D5, D95 and PTVmean for PTV3 were 61.22, 61.13, 58.12, 60.00 Gy and 62.41 62.24 59.53 61.12 Gy for IMRT and VMAT, respectively. The averages V60 for bladder and V30 for rectum were 22.81, 25 and 67, 65% for IMRT and VMAT, respectively. The average homogeneity index (HI), conformity index (CI) and gradient index (GI) were 1.04, 1.4833, 14.79 and 1.04, 1.704, 7.89 for IMRT and VMAT, respectively.

Conclusion:

VMAT takes less dose-delivery time and lesser number of monitoring units than IMRT, thus it compensates the intrafractional movements during dose delivery. The Dose GI in VMAT was much better than IMRT. This indicates sharper dose fall off near the normal tissue. No other major differences were observed in terms of plan evaluation parameters between IMRT and VMAT techniques. So, we conclude that VMAT technique is more efficient than IMRT in terms of plan quality and dose delivery.

Keywords

conformity indexgradient indexhomogeneity indexintensity-modulated radiotherapyvolumetric arc therapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 321 - 331
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Riou, O, de la Mothe, P R, Azria, D et al. Simultaneous integrated boost plan comparison of volumetric-modulated arc therapy and sliding window intensity-modulated radiotherapy for whole pelvis irradiation of locally advanced prostate cancer. J App Clin Med Phys 2013; 14 (4): 26–35.CrossRefGoogle ScholarPubMed
Gao, M, Li, Q, Ning, Z et al. Dosimetric comparison between step-shoot intensity-modulated radiotherapy and volumetric-modulated arc therapy for upper thoracic and cervical esophageal carcinoma. Med Dosim 2016; 41 (2): 131–135.CrossRefGoogle ScholarPubMed
Gautam, B. Literature review on IMRT and VMAT for prostate cancer. Am J Cancer Rev 2014; 2 (1): 5.Google Scholar
Mellon, E A, Javedan, K, Strom, T J et al. A dosimetric comparison of volumetric modulated arc therapy with step-and-shoot intensity modulated radiation therapy for prostate cancer. Pract Radiat Oncol 2015; 5 (1): 11–15.CrossRefGoogle ScholarPubMed
Franzese, C, Fogliata, A, D’Agostino, G R et al. Moderate hypofractionated radiotherapy with volumetric modulated arc therapy and simultaneous integrated boost for pelvic irradiation in prostate cancer. J Cancer Res Clin Oncol 2017; 143 (7): 1301–1309.CrossRefGoogle ScholarPubMed
Hesselberg, G, Fogarty, G, Haydu, L et al. Volumetric modulated arc therapy of the pelvic lymph nodes to the aortic bifurcation in higher risk prostate cancer: early toxicity outcomes. BioMed Res Int 2015; 2015: 696439.CrossRefGoogle ScholarPubMed
Ishii, K, Ogino, R, Hosokawa, Y et al. Whole-pelvic volumetric-modulated arc therapy for high-risk prostate cancer: treatment planning and acute toxicity. J Radiat Res 2015; 56 (1): 141–150.CrossRefGoogle ScholarPubMed
Daoud, M A, Saleh, Y M, Elsherbini, M et al. Evaluation of acute toxicity and dosimetric parameters in high risk prostate cancer patients treated by high radiation doses. J Cancer Ther 2019; 10 (8): 654.CrossRefGoogle Scholar
Onal, C, Sonmez, S, Erbay, G et al. Simultaneous integrated boost to intraprostatic lesions using different energy levels of intensity-modulated radiotherapy and volumetric-arc therapy. Brit J Radiol 2014; 87 (1034): 20130617.CrossRefGoogle ScholarPubMed
Johnson, D, Osei, E, Fleck, A et al. Retrospective dosimetric evaluation of VMAT plans for prostate cancer treatment. J Radiother Pract 2019; 18 (2): 155–164.Google Scholar
Tsai, C-L, Wu, J-K, Chao, H-L et al. Treatment and dosimetric advantages between VMAT, IMRT, and helical tomotherapy in prostate cancer. Med Dosim 2011; 36 (3): 264–271.CrossRefGoogle ScholarPubMed
Zhang, P, Happersett, L, Hunt, M et al. Volumetric modulated arc therapy: planning and evaluation for prostate cancer cases. Int J Radiat Oncol Biol Phys 2010; 76 (5): 1456–1462.CrossRefGoogle ScholarPubMed
Ost, P, Speleers, B, De Meerleer, G et al. Volumetric arc therapy and intensity-modulated radiotherapy for primary prostate radiotherapy with simultaneous integrated boost to intraprostatic lesion with 6 and 18 MV: a planning comparison study. Int J Radiat Oncol Biol Phys 2011; 79 (3): 920–926.CrossRefGoogle ScholarPubMed
Yoo, S, Wu, Q J, Lee, W R et al. Radiotherapy treatment plans with RapidArc for prostate cancer involving seminal vesicles and lymph nodes. Int J Radiat Oncol Biol Phys 2010; 76 (3): 935–942.CrossRefGoogle ScholarPubMed
Wolff, D, Stieler, F, Welzel, G et al. Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol 2009; 93 (2): 226–233.CrossRefGoogle ScholarPubMed
David, D, Syndikus, I, Mossop, H et al. Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol 2016; 17 (8): 1047–1060.Google Scholar
Lee, W R. Hypofractionation for prostate cancer: tested and proven. Lancet Oncol 2016; 17 (8): 1020–1022.CrossRefGoogle ScholarPubMed
Myrehaug, S, Chan, G, Craig, T et al. A treatment planning and acute toxicity comparison of two pelvic nodal volume delineation techniques and delivery comparison of intensity-modulated radiotherapy versus volumetric modulated arc therapy for hypofractionated high-risk prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys 2012; 82 (4): e657–e662.CrossRefGoogle ScholarPubMed
Sale, C, Moloney, P. Dose comparisons for conformal, IMRT and VMAT prostate plans. J Med Imaging Radiat Oncol 2011; 55 (6): 611–621.CrossRefGoogle ScholarPubMed
Pasler, P, Georg, D, Wirtz, H et al. Effect of photon-beam energy on VMAT and IMRT treatment plan quality and dosimetric accuracy for advanced prostate cancer. Strahlentherapie und Onkologie 2011; 187 (12): 792–798.CrossRefGoogle ScholarPubMed
Jo, G S, Kim, M W, Baek, M G et al. Dosimetric comparison for Prostate VMAT of weight and photon energy change. J Korean Soc Radiat Ther 2018; 30 (1_2): 17–25.Google Scholar
Yoon, M, Park, S Y, Shin, D et al. A new homogeneity index based on statistical analysis of the dose–volume histogram. J Appl Clin Med Phys 2007; 8 (2): 9–17.CrossRefGoogle ScholarPubMed
Chow, J C, Jiang, R, Kiciak, A et al. Dosimetric comparison between the prostate intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) plans using the planning target volume (PTV) dose–volume factor. J Radiother Pract 2016; 15 (3): 263–268.CrossRefGoogle Scholar
Cilla, S, Deodato, F, Digesù, C et al. Assessing the feasibility of volumetric-modulated arc therapy using simultaneous integrated boost (SIB-VMAT): an analysis for complex head-neck, high-risk prostate and rectal cancer cases. Med Dosim 2014; 39 (1): 108–116.CrossRefGoogle ScholarPubMed
Paddick, I, Lippitz, B. A simple dose gradient measurement tool to complement the conformity index. J Neurosurg 2006; 105 (Supplement): 194–201.CrossRefGoogle ScholarPubMed
Maraghechi, B, Davis, J, Badu, S et al. Retrospective analysis of portal dosimetry pre-treatment quality assurance of prostate volumetric-modulated arc therapy (VMAT) plans. J Radiother Pract 2018; 17 (1): 44–52.CrossRefGoogle Scholar
Schreibmann, E, Dhabaan, A, Elder, E et al. Patient-specific quality assurance method for VMAT treatment delivery. Med Phys 2009; 36 (10): 4530–4535.CrossRefGoogle ScholarPubMed
Esposito, M, Bruschi, A, Bastiani, P et al. Characterization of EPID software for VMAT transit dosimetry. Australas Phys Eng Sci Med 2018; 41 (4): 1021–1027.CrossRefGoogle ScholarPubMed
Xu, L-M, Kang, M-L, Jiang, B et al. A study of the dosimetric characteristics between different fixed-field IMRT and VMAT in early-stage primary mediastinal B-cell lymphoma. Med Dosim 2018; 43 (1): 91–99.CrossRefGoogle ScholarPubMed
Quan, E M, Li, X, Li, Y et al. A comprehensive comparison of IMRT and VMAT plan quality for prostate cancer treatment. Int J Radiat Oncol Biol Phys 2012; 83 (4): 1169–1178.CrossRefGoogle ScholarPubMed
Iqbal, K, Isa, M, Buzdar, S A et al. Treatment planning evaluation of sliding window and multiple static segments technique in intensity modulated radiotherapy. Rep Pract Oncol Radiother 2013; 18 (2): 101–106.CrossRefGoogle Scholar
Zulkafal, H M, Khan, M A, Ahmad, M W et al. Volumetric modulated arc therapy treatment planning assessment for low-risk prostate cancer in radiotherapy. Clin Cancer Investig J 2017; 6 (4): 179.CrossRefGoogle Scholar
Kopp, R W, Duff, M, Catalfamo, F et al. VMAT vs. 7-field-IMRT: assessing the dosimetric parameters of prostate cancer treatment with a 292-patient sample. Med Dosim 2011; 36 (4): 365–372.CrossRefGoogle ScholarPubMed