• J Med Imaging Radiat Oncol · Apr 2012

    Comparative Study

    Optimising the dosimetric quality and efficiency of post-prostatectomy radiotherapy: a planning study comparing the performance of volumetric-modulated arc therapy (VMAT) with an optimised seven-field intensity-modulated radiotherapy (IMRT) technique.

    • Brandon T Nguyen, Colin Hornby, Tomas Kron, Jim Cramb, Aldo Rolfo, Daniel Pham, Annette Haworth, Keen-Hun Tai, and Farshad Foroudi.
    • Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Vic. 8006, Australia. btnguyen321@yahoo.com.au
    • J Med Imaging Radiat Oncol. 2012 Apr 1; 56 (2): 211-9.

    PurposeThe purpose of this study was to compare and evaluate radiotherapy treatment plans using volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) for post-prostatectomy radiotherapy.Methods And MaterialsThe quality of radiotherapy plans for 10 patients planned and treated with a seven-field IMRT technique for biochemical failure post-prostatectomy were subsequently compared with 10 prospectively planned single-arc VMAT plans using the same computed tomography data set and treatment planning software. Plans were analysed using parameters to assess for target volume coverage, dose to organs at risk (OAR), biological outcomes, dose conformity and homogeneity, as well as the total monitor units (MU), planning and treatment efficiency.ResultsThe mean results for the study population are reported for the purpose of comparison. For IMRT, the median dose to the planning target volume, V(95%) and D(95%) was 71.1 Gy, 98.9% and 68.3 Gy compared with 71.2 Gy, 99.2% and 68.6 Gy for VMAT. There was no significant difference in the conformity index or homogeneity index. The VMAT plans achieved better sparing of the rectum and the left and right femora with a reduction in the median dose by 7.9, 6.3 and 3.6 Gy, respectively. The total number of monitor units (MU) was reduced by 24% and treatment delivery time by an estimated 3 min per fraction without a significant increase in planning requirements.ConclusionsVMAT can achieve post-prostatectomy radiotherapy plans of comparable quality to IMRT with the potential to reduce dose to OAR and improve the efficiency of treatment delivery.© 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

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