A muti-center plan comparison for volumetric modulated arc therapy
LI Ming-hui*, HU Cai-rong, LI Guang-jun, YUN Wei-kang, ZHANG Dan-dan, CHEN Nian-yong, LI Jian-cheng, LI Xiang-lan, LIANG Jun, SUN Ying, BAI San, BAI Yan-ling, HUANG Xiao-yan, ZHANG Xiu-chun, DAI Jian-rong.*
Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021,China
Abstract：Objective To evaluate the quality of volumetric modulated arc therapy (VMAT) plans among the sites and establish the common template for VMAT plan. Methods One test case was provided by each of five sites accordingly, and the CT with contours was send to the TPS after approved. All participants were asked to wake the VMAT plans for these test cases with uniform dose prescription and follow the planning strategy of their choice. Each test case includes five plans designed by the participants and one plan generated with the template. The quality score was used to evaluate the plan quality, and the MU with treatment time was used for execution efficiency. Results For NPC case, no plan was able to fulfill all dose objectives strictly;three plans failed some of the objectives but were still considered to be clinically acceptable;the other three plans were not able to reach the objectives. For Esophagus case, all six plans were considered to be clinically acceptable. For lung case, four plans were considered to be clinically acceptable;two plans were not able to reach the objectives. For Prostate case, four plans were able to fulfill all dose objectives strictly;one plan was still considered to be clinically acceptable;one plan was not able to reach the objectives. For Liver case, three plans were able to fulfill all dose objectives strictly;three plans were considered to be clinically acceptable. About the execution efficiency, treatment duration was 3—7 min, amount of MU was 350—900 MU, amount of control points was 80—160. Conclusions The presented planning studies showed that quality and execution efficiency for most plan have achieved the clinical requirements;the quality of VMAT plan′s template and benchmark database also meet the expectation.
[1] Yu CX. Intensity-modulated arc therapy with dynamic multileaf collimation:an alternative to tomotherapy. Phys Med Biol,1995,40:1435-1449. [2] Ma L, Yu CX, Earl M, et al. Optimized intensity‐modulated arc therapy for prostate cancer treatment. Int J Cancer,2001,96:379-384. [3] Yu CX, Li XA, Ma L,et al. Clinical implementation of intensity-modulated arc therapy. Int J Radiat Oncol Biol Phys,2002,53:453-463. [4] Bratengeier K. Applications of two-step intensity modulated arc therapy. Strahlenther Onkol,2001,177:394-403. [5] Duthoy W, De Gersem W, Vergote K, et al. Clinical implementation of intensity-modulated arc therapy (IMAT) for rectal cancer. Int J Radiat Oncol Biol Phys,2004,60:794-806. [6] Otto K. Volumetric modulated arc therapy:IMRT in a single gantry arc. Med Phys,2008,35:310-317. [7] Wolff D, Stieler F, Welzel G, et al. Volumetric modulated arc therapy (VMAT) vs. serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol,2009,93:226-233. [8] Bertelsen A, Hansen CR, Johansen J, et al. Single arc volumetric modulated arc therapy of head and neck cancer. Radiother Oncol,2010,95:142-148. [9] Wu QJ, Yoo S, Kirkpatrick JP, et al. Volumetric arc intensity-modulated therapy for spine body radiotherapy:comparison with static intensity-modulated treatment. Int J Radiat Oncol Biol Phys,2009,75:1596-1604. [10] Bohsung J, Gillis S, Arrans R, et al. IMRT treatment planning-A comparative inter-system and inter-centre planning exercise of the ESTRO QUASIMODO group. RadiotherOncol,2005,76:354-361. [11] van′t Riet A, Mak AC, Moerland MA, et al. A conformation number to quantify the degree of conformality inbrachytherapy and external beam irradiation:application to the prostate. Int J Radiat Oncol Biol Phys,1997,37:731-736. [12] Hodapp N. The ICRU Report 83:prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT). Strahlenther Onkol,2012,188:97-99. [13] McGrath SD, Matuszak MM, Yan D, et al. Volumetric modulated arc therapy for delivery of hypofractionated stereotactic lung radiotherapy:a dosimetric and treatment efficiency analysis. Radiother Oncol,2010,95:153-157. [14] Yang D, Moore KL. Automated radiotherapy treatment plan integrity verification. Med Phys,2012,39:1542-1551. [15] Clark CH, Hansen VN, Chantler H, et al. Dosimetry audit for a multi-centre IMRT head and neck trial. Radiother Oncol,2009,93:102-108. [16] Chung HT, Lee B, Park E, et al. Can all centers plan intensity-modulated radiotherapy (IMRT) effectively? An external audit of dosimetric comparisons between three-dimensional conformal radiotherapy and IMRT for adjuvant chemoradiation for gastric cancer. Int J Radiat Oncol Biol Phys,2008,71:1167-1174. [17] Budgell G, Berresford J, Trainer M, et al. A national dosimetric audit of IMRT. Radiother Oncol,2011,99:246-252. [18] 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,2009,36:5359-5573. [19] Feygelman V, Zhang G, Stevens C. Initial dosimetric evaluation of SmartArc-a novel VMAT treatment planning module implemented in a multi-vendor delivery chain. J Appl Clin Med Phys,2010,11:3169. [20] Holt A, Van Gestel D, Arends MP, et al. Multi-institutional comparison of volumetric modulated arc therapy vs. intensity-modulated radiation therapy for head-and-neck cancer:a planning study. Radiat Oncol,2013,8:26[2013-06-10]. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599974/
2013, Vol. 22 
