HyperArc与VMAT技术脑转移瘤应用比较

doi:10.3760/cma.j.cn113030-20201031-00523

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Abstract Objective To compare the dosimetric parameters and plan complexity between newly-delicated HyperArc (HA) and conventional volumetric-modulated arc therapy (VMAT) in the treatment of brain metastases. Methods For 26 patients with brain metastases, HA, conventional coplanar (Cop) and non-coplanar (Non-cop) VMAT plans with a prescription dose of 9Gy 3fx or 6Gy 5fx were generated. The dosimetric parameters for planning target volume (PTV), RTOG conformity index (RTOG CI), Paddick CI, homogeneity index (HI), gradient index (GI), maximum dose (Dmax) of brainstem and dose-volume parameters of brain-PTV(V2Gy-V26Gy) were statisticaly compared among these three approaches. In addition, the monitor unit (MU) and the plan complexity parameters (including MCSv and AlPO) were statistically compared. Results To prevent missed targets during treatment, all plans were established with RTOG CI of greater than 1.1. For Paddick CI, HA provided significantly higher conformity (0.89±0.019) than Non-cop (0.87±0.036, P=0.001) and Cop (0.88±0.017, P=0.003) VMAT. For GI, the fastest dose fall-off was noted in HA (3.35±0.64), followed by conventional Non-cop VMAT of (3.70±0.80), and conventional Cop VMAT of (4.90±1.85)(all P<0.05). For the brainstem sparing, HA plan performed better than Non-cop plan[(604.14±531.61) cGy vs.(682.75±558.22) cGy, P<0.05)]. For normal brain tissue sparing, HA approach showed significant reduction than conventional Cop and Non-cop VMAT (both P<0.05). For MU, HA approach (2872.60 ± 566.93) was significantly lower than those of Non-cop VMAT (3771.28 ± 1022.38, P<0.05) and Cop VMAT (4494.08 ± 1323.09, P<0.05). In terms of plan complexity, the MCSv of Cop plan was the lowest, indicating that the complexity was the highest (P<0.05). The AlPO of HA was significantly higher than that of Non-cop VMAT (P<0.05), suggesting that the complexity of HA plan was lower (P<0.05). Conclusion For the treatment of brain metastases, HA provides better conformity, more rapid dose fall-off, better sparing of brainstem and normal brain tissues and less plan complexity compared with conventional VMAT.

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	Articles by authors
	Yang Bo
	Yu Lang
	Wang Zhiqun
	Wang Bei
	Li Wenbo
	Zhang Jie
	Wang Xingliu
	Zhu Hao
	Wang Xiaoshen
	Lan Maoying
	Zhu Feng
	Zhang Zhen
	Hu Ke
	Zhang Fuquan
	Qiu Jie

Key words： HyperArc technique Volumetric-modulated arc therapy technique Brain metastasis/radiotherapy

Received: 31 October 2020

Fund:National Key Research & Development Program during the 13^th Five-year Plan Period (2016YFC0105206,2016YFC0105207)

Corresponding Authors: Qiu Jie, Email:qj_ww@139.com

Cite this article:

Yang Bo,Yu Lang,Wang Zhiqun et al. Comparison between HyperArc and conventional VMAT approach for brain metastases[J]. Chinese Journal of Radiation Oncology, 2021, 30(9): 876-881.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20201031-00523 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I9/876

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