International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Commissioning of volumetric modulated arc therapy (VMAT).
Volumetric modulated arc therapy (VMAT) involves the simultaneous use of dynamic multileaf collimator (DMLC) techniques and gantry arcing; appropriate quality assurance is therefore required. This article describes the development and implementation of procedures for commissioning VMAT on a commercial linear accelerator (Elekta PreciseBeam VMAT with MLCi and Beam Modulator heads). ⋯ VMAT has been successfully commissioned and has been introduced into clinical use. The Elekta DMLC has also been shown to be suitable for sliding window delivery.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Conformity of LINAC-based stereotactic radiosurgery using dynamic conformal arcs and micro-multileaf collimator.
To assess the conformity of dynamic conformal arc linear accelerator-based stereotactic radiosurgery and to describe a standardized method of isodose surface (IDS) selection. ⋯ The CIs obtained with linear accelerator-based stereotactic radiosurgery are comparable to those previously reported for gamma knife stereotactic radiosurgery. Using a uniform method to select the sIDS, adequate target coverage was usually achievable with prescription to an IDS greater than that chosen by the treating physician (prescription IDS), providing sparing of normal tissue. Thus, the sIDS might aid physicians in identifying a prescription IDS that balances coverage and conformity.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Accelerated hypofractionated intensity-modulated radiotherapy with concurrent and adjuvant temozolomide for patients with glioblastoma multiforme: a safety and efficacy analysis.
Despite multimodality treatments, the outcome of patients with glioblastoma multiforme remains poor. In an attempt to improve results, we have begun a program of accelerated hypofractionated intensity-modulated radiotherapy (hypo-IMRT) with concomitant and adjuvant temozolomide (TMZ). ⋯ The results of our study have shown that hypo-IMRT with concomitant and adjuvant TMZ is well tolerated with a useful 2-week shortening of radiotherapy. Despite a high number of patients with poor prognostic features (74.3% recursive partitioning analysis class V or VI), the median survival was comparable to that after standard radiotherapy fractionation schedules plus TMZ.
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Int. J. Radiat. Oncol. Biol. Phys. · Feb 2009
Evaluating the relationships between rectal normal tissue complication probability and the portion of seminal vesicles included in the clinical target volume in intensity-modulated radiotherapy for prostate cancer.
To compare dose-volume consequences of the inclusion of various portions of the seminal vesicles (SVs) in the clinical target volume (CTV) in intensity-modulated radiotherapy (IMRT) for patients with prostate cancer. ⋯ Doubling (1 to 2 cm) or comprehensively increasing (1 cm to full SVs) SV volume included in the CTV for patients with prostate IMRT is achievable in the majority of cases without exceeding RTOG dose-volume limits or underdosing the PTV and results in only a moderate increase in NTCP.