Trajectory Modulated Arc Therapy: A Fully Dynamic Delivery With Synchronized Couch and Gantry Motion Significantly Improves Dosimetric Indices Correlated With Poor Cosmesis in Accelerated Partial Breast Irradiation.
Purpose: To develop planning and delivery capabilities for linear accelerator-based nonisocentric trajectory modulated arc therapy (TMAT) and to evaluate the benefit of TMAT for accelerated partial breast irradiation (APBI) with the patient in prone position.Methods and Materials: An optimization al...
| Publicado en: | International Journal of Radiation Oncology, Biology, Physics Vol. 92; no. 5; pp. 1148 - 1157 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Pergamon Press - An Imprint of Elsevier Science
Aug2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109604478&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109604478 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03603016 1ZQ jtl: International Journal of Radiation Oncology, Biology, Physics issn: 03603016 maglogo: N pubinfo: dt: Aug2015 vid: 92 iid: 5 pid: 2410 pub: Pergamon Press - An Imprint of Elsevier Science artinfo: ui: 109604478 NLM26050608 2013106278 10.1016/j.ijrobp.2015.04.034 NLM26050608 109604478 ppf: 1148 ppct: 9 formats: tig: atl: Trajectory Modulated Arc Therapy: A Fully Dynamic Delivery With Synchronized Couch and Gantry Motion Significantly Improves Dosimetric Indices Correlated With Poor Cosmesis in Accelerated Partial Breast Irradiation. aug: au: Liang, Jieming Atwood, Todd von Eyben, Rie Fahimian, Benjamin Chin, Erika Horst, Kathleen Otto, Karl Hristov, Dimitre affil: Department of Radiation Oncology, Stanford University, California. sug: ab: Purpose: To develop planning and delivery capabilities for linear accelerator-based nonisocentric trajectory modulated arc therapy (TMAT) and to evaluate the benefit of TMAT for accelerated partial breast irradiation (APBI) with the patient in prone position.Methods and Materials: An optimization algorithm for volumetrically modulated arc therapy (VMAT) was generalized to allow for user-defined nonisocentric TMAT trajectories combining couch rotations and translations. After optimization, XML scripts were automatically generated to program and subsequently deliver the TMAT plans. For 10 breast patients in the prone position, TMAT and 6-field noncoplanar intensity modulated radiation therapy (IMRT) plans were generated under equivalent objectives and constraints. These plans were compared with regard to whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose.Results: For TMAT APBI, nonisocentric collision-free horizontal arcs with large angular span (251.5 ± 7.9°) were optimized and delivered with delivery time of ∼4.5 minutes. Percentage changes of whole breast tissue volume receiving more than 100%, 80%, 50%, and 20% of the prescription dose for TMAT relative to IMRT were -10.81% ± 6.91%, -27.81% ± 7.39%, -14.82% ± 9.67%, and 39.40% ± 10.53% (P≤.01).Conclusions: This is a first demonstration of end-to-end planning and delivery implementation of a fully dynamic APBI TMAT. Compared with IMRT, TMAT resulted in marked reduction of the breast tissue volume irradiated at high doses. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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