PMID- 21752615
OWN - NLM
STAT- MEDLINE
DCOM- 20120710
LR  - 20220311
IS  - 1433-2981 (Electronic)
IS  - 0936-6555 (Linking)
VI  - 24
IP  - 3
DP  - 2012 Apr
TI  - Dual arc volumetric-modulated arc radiotherapy (VMAT) of nasopharyngeal 
      carcinomas: a simultaneous integrated boost treatment plan comparison with 
      intensity-modulated radiotherapies and single arc VMAT.
PG  - 196-207
LID - 10.1016/j.clon.2011.06.006 [doi]
AB  - AIMS: To compare the performance of volumetric-modulated arc radiotherapy (VMAT) 
      by dual arc with fixed beam intensity-modulated radiotherapies (IMRTs) and single 
      arc VMAT on nasopharyngeal carcinomas (NPC). MATERIALS AND METHODS: Twenty NPC 
      cases were re-planned using the planning system of the Pinnacle(3(R))SmartArc (SA) 
      module to compare the performance of the following four techniques: seven-field 
      (7F) and 18-field (18F) fixed beam IMRT, and single (SA(1)) and dual arc VMAT 
      (SA(2)). The plan was delivered on an Elekta Synergy Linac equipped with an 
      80-leaf 1cm multileaf collimator. Three dose levels of planning target volumes 
      (PTVs) with 70/59.4/54.0Gy in 33 fractions were prescribed and delivered as a 
      simultaneous integrated boost. The conformity index and homogeneity index of the 
      PTVs, the comprehensive quality index (CQI), the normal tissue complication 
      probability for the organs at risk (OARs), and the planning time, delivery 
      efficiency and accuracy were analysed. RESULTS: A significantly inferior 
      conformity index at the three dose levels of PTV and homogeneity index of PTV(70) 
      were observed in SA(1) compared with the other techniques. Comparable conformity 
      index and homogeneity index of the PTV were observed among 7F/18F IMRT and SA(2). 
      Based on the CQI of the 11 OARs, the most efficient dose reduction was observed 
      in 18F IMRT followed in order by SA(2), 7F IMRT and SA(1). The planning time was 
      on average 13.2/24.9/40.1/42.8min for 7F/18F IMRT/SA(1)/SA(2), respectively. With 
      regards to the delivery efficiency compared with 7F IMRT, a 51 and 41% reduction 
      in delivery time was achieved by SA(1) and SA(2), respectively. All techniques 
      presented a high quality assurance pass rate (>98%) of the Gamma(3mm,3%) criterion. 
      CONCLUSION: In NPC cases, SA(2) gave superior results in terms of PTV coverage 
      and OAR sparing compared with SA(1) and approached the performance achieved by 
      18F IMRT, but without sacrificing the delivery efficiency.
CI  - Copyright (c) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. 
      All rights reserved.
FAU - Lee, T-F
AU  - Lee TF
AD  - Medical Physics & Informatics Laboratory, Department of Electronics Engineering, 
      National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan. 
      tflee@cc.kuas.edu.tw
FAU - Ting, H-M
AU  - Ting HM
FAU - Chao, P-J
AU  - Chao PJ
FAU - Fang, F-M
AU  - Fang FM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110712
PL  - England
TA  - Clin Oncol (R Coll Radiol)
JT  - Clinical oncology (Royal College of Radiologists (Great Britain))
JID - 9002902
SB  - IM
MH  - Adult
MH  - Carcinoma
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasopharyngeal Carcinoma
MH  - Nasopharyngeal Neoplasms/*radiotherapy
MH  - Organs at Risk/*radiation effects
MH  - Photons/*therapeutic use
MH  - Prognosis
MH  - *Quality Assurance, Health Care
MH  - Radiotherapy Dosage
MH  - *Radiotherapy Planning, Computer-Assisted
MH  - *Radiotherapy, Intensity-Modulated
EDAT- 2011/07/15 06:00
MHDA- 2012/07/11 06:00
CRDT- 2011/07/15 06:00
PHST- 2010/10/13 00:00 [received]
PHST- 2011/04/24 00:00 [revised]
PHST- 2011/05/05 00:00 [accepted]
PHST- 2011/07/15 06:00 [entrez]
PHST- 2011/07/15 06:00 [pubmed]
PHST- 2012/07/11 06:00 [medline]
AID - S0936-6555(11)00713-8 [pii]
AID - 10.1016/j.clon.2011.06.006 [doi]
PST - ppublish
SO  - Clin Oncol (R Coll Radiol). 2012 Apr;24(3):196-207. doi: 
      10.1016/j.clon.2011.06.006. Epub 2011 Jul 12.