PMID- 19560880
OWN - NLM
STAT- MEDLINE
DCOM- 20100331
LR  - 20220408
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 76
IP  - 4
DP  - 2010 Mar 15
TI  - A comparison of volumetric modulated arc therapy and conventional 
      intensity-modulated radiotherapy for frontal and temporal high-grade gliomas.
PG  - 1177-84
LID - 10.1016/j.ijrobp.2009.03.013 [doi]
AB  - PURPOSE: Volumetric modulated arc therapy (VMAT), the predecessor to Varian's 
      RapidArc, is a novel extension of intensity-modulated radiotherapy (IMRT) wherein 
      the dose is delivered in a single gantry rotation while the multileaf collimator 
      leaves are in motion. Leaf positions and the weights of field samples along the 
      arc are directly optimized, and a variable dose rate is used. This planning study 
      compared seven-field coplanar IMRT (cIMRT) with VMAT for high-grade gliomas that 
      had planning target volumes (PTVs) overlapping organs at risk (OARs). METHODS AND 
      MATERIALS: 10 previously treated patients were replanned to 60 Gy in 30 fractions 
      with cIMRT and VMAT using the following planning objectives: 98% of PTV covered 
      by 95% isodose without violating OAR and hotspot dose constraints. Mean OAR doses 
      were maximally decreased without reducing PTV coverage or violating hotspot 
      constraints. We compared dose-volume histogram data, monitor units, and treatment 
      times. RESULTS: There was equivalent PTV coverage, homogeneity, and conformality. 
      VMAT significantly reduced maximum and mean retinal, lens, and contralateral 
      optic nerve doses compared with IMRT (p < 0.05). Brainstem, chiasm, and 
      ipsilateral optic nerve doses were similar. For 2-Gy fractions, mean monitor 
      units were as follows: cIMRT = 789 +/- 112 and VMAT = 363 +/- 45 (relative 
      reduction 54%, p = 0.002), and mean treatment times (min) were as follows: cIMRT 
      = 5.1 +/- 0.4 and VMAT = 1.8 +/- 0.1 (relative reduction 65%, p = 0.002). 
      CONCLUSIONS: Compared with cIMRT, VMAT achieved equal or better PTV coverage and 
      OAR sparing while using fewer monitor units and less time to treat high-grade 
      gliomas.
CI  - Copyright 2010 Elsevier Inc. All rights reserved.
FAU - Shaffer, Richard
AU  - Shaffer R
AD  - Department of Radiation Oncology, BC Cancer Agency, Vancouver, British Columbia 
      V5Z 4E6, Canada.
FAU - Nichol, Alan M
AU  - Nichol AM
FAU - Vollans, Emily
AU  - Vollans E
FAU - Fong, Ming
AU  - Fong M
FAU - Nakano, Sandy
AU  - Nakano S
FAU - Moiseenko, Vitali
AU  - Moiseenko V
FAU - Schmuland, Moira
AU  - Schmuland M
FAU - Ma, Roy
AU  - Ma R
FAU - McKenzie, Michael
AU  - McKenzie M
FAU - Otto, Karl
AU  - Otto K
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090627
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Brain Neoplasms/pathology/*radiotherapy
MH  - Brain Stem/radiation effects
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Glioma/pathology/*radiotherapy
MH  - Humans
MH  - Lens, Crystalline/radiation effects
MH  - Male
MH  - Optic Nerve/radiation effects
MH  - Radiation Injuries/*prevention & control
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Retina/radiation effects
MH  - Tumor Burden
EDAT- 2009/06/30 09:00
MHDA- 2010/04/01 06:00
CRDT- 2009/06/30 09:00
PHST- 2008/08/27 00:00 [received]
PHST- 2009/03/03 00:00 [revised]
PHST- 2009/03/05 00:00 [accepted]
PHST- 2009/06/30 09:00 [entrez]
PHST- 2009/06/30 09:00 [pubmed]
PHST- 2010/04/01 06:00 [medline]
AID - S0360-3016(09)00419-2 [pii]
AID - 10.1016/j.ijrobp.2009.03.013 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2010 Mar 15;76(4):1177-84. doi: 
      10.1016/j.ijrobp.2009.03.013. Epub 2009 Jun 27.