PMID- 23246253
OWN - NLM
STAT- MEDLINE
DCOM- 20131204
LR  - 20130430
IS  - 1873-4022 (Electronic)
IS  - 1873-4022 (Linking)
VI  - 38
IP  - 2
DP  - 2013 Summer
TI  - Clinical experience transitioning from IMRT to VMAT for head and neck cancer.
PG  - 171-5
LID - S0958-3947(12)00189-6 [pii]
LID - 10.1016/j.meddos.2012.10.009 [doi]
AB  - To quantify clinical differences for volumetric modulated arc therapy (VMAT) 
      versus intensity modulated radiation therapy (IMRT) in terms of dosimetric 
      endpoints and planning and delivery time, twenty head and neck cancer patients 
      have been considered for VMAT using Nucletron Oncentra MasterPlan delivered via 
      an Elekta linear accelerator. Differences in planning time between IMRT and VMAT 
      were estimated accounting for both optimization and calculation. The average 
      delivery time per patient was obtained retrospectively using the record and 
      verify software. For the dosimetric comparison, all contoured organs at risk 
      (OARs) and planning target volumes (PTVs) were evaluated. Of the 20 cases 
      considered, 14 had VMAT plans approved. Six VMAT plans were rejected due to 
      unacceptable dose to OARs. In terms of optimization time, there was minimal 
      difference between the two modalities. The dose calculation time was 
      significantly longer for VMAT, 4 minutes per 358 degree arc versus 2 minutes for 
      an entire IMRT plan. The overall delivery time was reduced by 9.2 +/- 3.9 minutes 
      for VMAT (51.4 +/- 15.6%). For the dosimetric comparison of the 14 clinically 
      acceptable plans, there was almost no statistical difference between the VMAT and 
      IMRT. There was also a reduction in monitor units of approximately 32% from IMRT 
      to VMAT with both modalities demonstrating comparable quality assurance results. 
      VMAT provides comparable coverage of target volumes while sparing OARs for the 
      majority of head and neck cases. In cases where high dose modulation was required 
      for OARs, a clinically acceptable plan was only achievable with IMRT. Due to the 
      long calculation times, VMAT plans can cause delays during planning but marked 
      improvements in delivery time reduce patient treatment times and the risk of 
      intra-fraction motion.
CI  - Copyright (c) 2013 American Association of Medical Dosimetrists. Published by 
      Elsevier Inc. All rights reserved.
FAU - Studenski, Matthew T
AU  - Studenski MT
AD  - Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson 
      University, Philadelphia, PA 19107, USA. matthew.studenski@jeffersonhospital.org
FAU - Bar-Ad, Voichita
AU  - Bar-Ad V
FAU - Siglin, Joshua
AU  - Siglin J
FAU - Cognetti, David
AU  - Cognetti D
FAU - Curry, Joseph
AU  - Curry J
FAU - Tuluc, Madalina
AU  - Tuluc M
FAU - Harrison, Amy S
AU  - Harrison AS
LA  - eng
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20121214
PL  - United States
TA  - Med Dosim
JT  - Medical dosimetry : official journal of the American Association of Medical 
      Dosimetrists
JID - 8908862
SB  - IM
MH  - Head and Neck Neoplasms/*radiotherapy
MH  - Humans
MH  - Radiometry/*methods
MH  - *Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
EDAT- 2012/12/19 06:00
MHDA- 2013/12/16 06:00
CRDT- 2012/12/19 06:00
PHST- 2012/05/31 00:00 [received]
PHST- 2012/10/31 00:00 [revised]
PHST- 2012/10/31 00:00 [accepted]
PHST- 2012/12/19 06:00 [entrez]
PHST- 2012/12/19 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - S0958-3947(12)00189-6 [pii]
AID - 10.1016/j.meddos.2012.10.009 [doi]
PST - ppublish
SO  - Med Dosim. 2013 Summer;38(2):171-5. doi: 10.1016/j.meddos.2012.10.009. Epub 2012 
      Dec 14.