Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-23T10:38:19.040Z Has data issue: false hasContentIssue false
  • English
  • Français

VMAT treatment plan acceptability and quality assurance study for prostate cancer in radiotherapy

Published online by Cambridge University Press:  10 January 2020

Robina Sarwar ,
Saima Altaf Open the ORCID record for Saima Altaf [Opens in a new window] ,
Rao M. Afzal Khan ,
Saeed A. Buzdar  and
Khalid Iqbal
Robina Sarwar
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan
Saima Altaf*
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan Department of Physics, The Women University, Multan, Pakistan
Rao M. Afzal Khan
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan
Saeed A. Buzdar
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan
Khalid Iqbal
Affiliation:
Department of Physics, The Islamia University, Bahawalpur, Pakistan Department of Clinical & Radiation Oncology, Shaukat Khanum Cancer Hospital & Research Center, Lahore, Pakistan
*
Author of correspondence: Saima Altaf, Department of Physics, The Women University, Multan, Pakistan. Tel: +923000694166. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

The aim of this work was to study the acceptability of plans prepared for prostate patients treated by volumetric modulated arc therapy (VMAT) with the vision to evaluate the quality of plans and test pre-treatment quality assurance (QA).

Material methods:

VMAT plans of 35 patients, planned on the Eclipse Treatment Planning System (Aria 15), were included in the study. Plan acceptability was checked using statistical analysis, which includes homogeneity index, radical and median homogeneity index, coverage and uniformity index. Dose–volume histograms (DVH) of the plans were also studied to check prescribed dose (PD), Dmax, Dmin, D5 and D95. Portal dosimetry was also done by gamma analysis using 3%/3 mm criterion. SD and mean SD error were also calculated and analysed.

Results:

Statistical analysis showed a mean HI of 1·054, coverage 0·959, UI 1·055, mDHI 0·962 and rDHI 0·866. SD of HI, coverage, UI, mDHI and rDHI was 0·019, 0·019, 0·014, 0·013 and 0·030, respectively. From the DVHs, mean of D5, D95, Dmin and Dmax was calculated at 6,252·9, 5,757·4, 6,413·3 and 5,657·7 cGy, respectively, with a prescribed dose of 6,000 cGy. According to gamma analysis, area gamma < 1 was 99·12% with a tolerance limit of 95%, maximum gamma was 1·466 with a tolerance limit of 3·5, average gamma was 0·388 with a tolerance limit of 0·5, area gamma > 1·2 was 0·242% with a tolerance limit of 0·5%, maximum dose difference was 0·6 with a tolerance limit of 1·0 and average dose difference was 0·029 with a tolerance limit of 0·2.

Conclusion:

All three computations showed the results to be within acceptable limits. VMAT possesses a unique feature of delivering the whole treatment with only two rotations of the gantry. VMAT has an improved efficiency of delivery for equivalent dosimetric quality.

Keywords

dose homogeneityEPIDgamma analysisVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 1 , March 2021 , pp. 43 - 48
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Palma, D, Vollans, E, James, K et al. Volumetric modulated arc therapy for delivery of prostate radiotherapy: comparison with intensity-modulated radiotherapy and three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 2008; 72(4): 996–1001.CrossRefGoogle ScholarPubMed
Atiq, A, Atiq, M, Iqbal, K et al. A comparative study of VMAT and intensity-modulated radiotherapy plan quality for cervical cancer treatment. Indian J Cancer 2018; 55(1): 74–79.CrossRefGoogle ScholarPubMed
Zhang, P, Happersett, L, Hunt, M et al. Volumetric modulated arc therapy: planning and evaluation for prostate cancer cases. Int J Radiat Oncol Biol Phys 2010; 76: 1456–1462.CrossRefGoogle ScholarPubMed
Bedford, JL. Treatment planning for volumetric modulated arc therapy. Med Phys 2009; 36(51): 28–38.CrossRefGoogle ScholarPubMed
Rousseau, D, Autret, D, Krhili, S et al. La radiothérapie avec modulation d’intensité rotationnelle apporte-t-elle un avantage dosimétrique dans le traitement du cancer bronchique localement évolué. Cancer/Radiothérapie 2012; 16(7): 619–626.CrossRefGoogle Scholar
Voyant, C, Julian, D, Roustit, R, Biffi, K, Lantieri, C. Biological effects and equivalent doses in radiotherapy. Rep Pract Oncol Radiother 2013; 29: 47–55.Google Scholar
Landberg, T, Chavaudra, J, Dobbs, J et al. Prescribing, recording and reporting photon beam therapy, ICRU report #50. J Med Phys 1992; 17: 5–7.Google Scholar
Ma, CM, Jiang, SB, Pawlicki, T et al. A quality assurance phantom for IMRT dose verification. Phys Med Biol 2003; 48: 561–572.CrossRefGoogle ScholarPubMed
Hancock, SS. South East Missouri Hospital. Report on test on steps involving SRS treatment process with commercial Luci Phantom. 2008.Google Scholar
Ravichandran, R, Binukumar, JP, Sivakumar, SS, Krishnamurthy, K, Davis, CA. A method for estimation of accuracy of dose delivery with dynamic slit windows in medical linear accelerators. J Med Phys 2008; 33: 127–129.CrossRefGoogle ScholarPubMed
Low, DA, Harms, WB, Mutic, S et al. A technique for the quantitative evaluation of dose distributions. Med Phys 1998; 25(5): 656–661.CrossRefGoogle ScholarPubMed
Agazaryan, N, Solberg, TD, DeMarco, JJ. Patient specific quality assurance for the delivery of intensity modulated radiotherapy. J Appl Clin Med Phys 2003; 4(1): 40–50.CrossRefGoogle ScholarPubMed
Atiq, M, Atiq, A, Iqbal, K et al. Interpretation of gamma index for quality assurance of simultaneously integrated boost (SIB) IMRT plans for head and neck carcinoma. Polish J Med Phys Eng 2017; 23(4): 93–97.CrossRefGoogle Scholar
Low, DA, Dempsey, JF. Evaluation of the gamma dose distribution comparison method. Med Phys 2003; 30(9): 2455–2464.CrossRefGoogle ScholarPubMed
Zulkafal, HM, Khan, MA, MW, Ahmad et al. Volumetric modulated arc therapy treatment planning assessment for low-risk prostate cancer in radiotherapy. Clin. Cancer Investig J 2017; 6(4): 179–183.CrossRefGoogle Scholar
Chung, Jin Beom, Kim, Jae Sung, Ha, Sung Whan, Ye, Sung-Joon. Statistical analysis of IMRT dosimetry quality assurance measurements for local delivery guideline. Radiat Oncol (London, England) 2011; 6(27): 1–8.Google ScholarPubMed
Mijheer, B, Georg, D. Guidelines for the Verification of IMRT. Brussels, Belgium: ESTRO; 2008.Google Scholar
Ezzell, GA, Burmeister, JW, Dogan, N et al. IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. Med Phys 2009; 36(11): 5359–5373.CrossRefGoogle ScholarPubMed
Atiq, A, Atiq, M, Iqbal, K, Shamsi, QA, Buzdar, SA. Evaluation of various dose homogeneity indice s for treatment of patients with cervix cancer using intensity-modulated radiation therapy technique. J Radiother Pract 2018; 18(1): 1–6.Google Scholar
Shaw, E, Kline, R, Gillin, M et al. Radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys 1993; 27(5): 1231–1239.CrossRefGoogle ScholarPubMed
Oliver, M, Chen, J, Wong, E, Van Dyk, J, Perera, F. A treatment planning study comparing whole breast radiation therapy against conformal, IMRT and tomotherapy for accelerated partial breast irradiation. Radiother Oncol 2007; 82(3): 317–323.CrossRefGoogle ScholarPubMed
Chitapanarux, I, Tharavichitkul, E, Nobnop, W et al. A comparative planning study of step-and-shoot IMRT versus helical tomotherapy for whole-pelvis irradiation in cervical cancer. J Radiat Res 2015; 56: 539–545.CrossRefGoogle Scholar
Elawady, RA, Attalla, EM, Elshemey, WM et al. Dose verification of intensity modulated radiotherapy in head and neck tumors. Int J Cancer Ther Oncol 2014; 2(3): 02037.CrossRefGoogle Scholar
ICRU Report 83. Journal of the ICRU. Oxford University Press 2010; 10: 97–100.Google Scholar
Altaf, S, Iqbal, K, Akram, M, Buzdar, SA. Quality assurance of intensity-modulated radiotherapy treatment planning: a dosimetric comparison. J Radiother Pract 2018; 17: 396–402.CrossRefGoogle Scholar