A planning study investigating dual-gated volumetric arc stereotactic treatment of primary renal cell carcinoma

Devereux, T, Pham, D, Kron, T, Foroudi, F, Supple, J and Siva, S 2015, 'A planning study investigating dual-gated volumetric arc stereotactic treatment of primary renal cell carcinoma', Medical Dosimetry, vol. 40, no. 1, pp. 82-88.


Document type: Journal Article
Collection: Journal Articles

Title A planning study investigating dual-gated volumetric arc stereotactic treatment of primary renal cell carcinoma
Author(s) Devereux, T
Pham, D
Kron, T
Foroudi, F
Supple, J
Siva, S
Year 2015
Journal name Medical Dosimetry
Volume number 40
Issue number 1
Start page 82
End page 88
Total pages 7
Publisher Elsevier
Abstract This is a planning study investigating the dosimetric advantages of gated volumetric-modulated arc therapy (VMAT) to the end-exhale and end-inhale breathing phases for patients undergoing stereotactic treatment of primary renal cell carcinoma. VMAT plans were developed from the end-inhale (VMATinh) and the end-exhale (VMATexh) phases of the breathing cycle as well as a VMAT plan and 3-dimensional conformal radiation therapy plan based on an internal target volume (ITV) (VMATitv). An additional VMAT plan was created by giving the respective gated VMAT plan a 50% weighting and summing the inhale and exhale plans together to create a summed gated plan. Dose to organs at risk (OARs) as well as comparison of intermediate and low-dose conformity was evaluated. There was no difference in the volume of healthy tissue receiving the prescribed dose for the planned target volume (PTV) (CI100%) for all the VMAT plans; however, the mean volume of healthy tissue receiving 50% of the prescribed dose for the PTV (CI50%) values were 4.7 (± 0.2), 4.6 (± 0.2), and 4.7 (± 0.6) for the VMATitv, VMATinh, and VMATexh plans, respectively. The VMAT plans based on the exhale and inhale breathing phases showed a 4.8% and 2.4% reduction in dose to 30 cm3 of the small bowel, respectively, compared with that of the ITV-based VMAT plan. The summed gated VMAT plans showed a 6.2% reduction in dose to 30 cm3 of the small bowel compared with that of the VMAT plans based on the ITV. Additionally, when compared with the inhale and the exhale VMAT plans, a 4% and 1.5%, respectively, reduction was observed. Gating VMAT was able to reduce the amount of prescribed, intermediate, and integral dose to healthy tissue when compared with VMAT plans based on an ITV. When summing the inhale and exhale plans together, dose to healthy tissue and OARs was optimized. However, gating VMAT plans would take longer to treat and is a factor that needs to be considered.
Subject Physical Sciences not elsewhere classified
Keyword(s) Gating
Renal cell carcinoma
Stereotactic body radiation therapy
Volumetric arc therapy
DOI - identifier 10.1016/j.meddos.2014.11.001
Copyright notice © 2015 Published by Elsevier Inc. on behalf of American Association of Medical Dosimetrists
ISSN 0958-3947
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