Department of Radiation Oncology,Shandong Cancer Hospital and Institute,Ji’nan 250117,China (Duan JH,Li CHQ,Gong GZH,Tao CH,Liu X,Zhu J,Yin Y);
Depatment of Radoation Oncology,Tumor Hospital of Xinjiang Medical University,Urumqi 830000,China (Wang RZH)
Objective To evaluate the dosimetric difference between volumetric modulated arc therapy (VMAT) plans with and without an interdigitating multileaf collimator (MLC) in the treatment of multiple brain metastases, and to investigate the advantages of MLC interdigitation in VMAT plans for multiple brain metastasis. Methods A retrospective study was performed on clinical data from 15 patients with multiple brain metastases in our hospital. A dual arc VMAT plan with an interdigitating MLC (VMAT-1) was designed on computed tomography (CT) images. Then, keeping all parameters unchanged, another VMAT plan with a non-interdigitating MLC (VMAT-2) was made after re-optimization. The conformity index (CI) and homogeneity index (HI) of the planning target volume (PTV), doses to organs at risk (OARs), monitor units (MUs), control points, delivery time, and planning time were compared between the two treatment plans using the Wilcoxon signed rank test. Results VMAT-1 achieved a better HI than VMAT-2(P=0.04), while there was no significant difference in CI between the two plans (P=0.33). VMAT-1 had a significantly higher D98% for PTV than VMAT-2(P=0.04). Compared with VMAT-2, the Dmean to the brain stem in VMAT-1 was significantly reduced by 4%(P=0.04). The doses to other OARs in VMAT-1 were similar to those in VMAT-2. In some patients, compared with VMAT-2, VMAT-1 had a lower dose to normal tissue at the junction of neighboring CT planes of tumor. Compared with VMAT-2, the MUs of VMAT-1 were significantly increased by 4%(P=0.01), while there were no significant differences in control points or delivery time between the two plans (P=0.81, 0.73). VMAT-1 had the planning time significantly reduced by 26% compared with VMAT-2(P=0.00). Conclusions In VMAT plans for multiple brain metastases, MLC interdigitation could save the VMAT planning time and improve the planning efficiency.
National Natural Science Foundation of China (81472811, 81272699);Science and Technology Development Planning Projects of Shandong Province (2014GSFll8011)
Corresponding Authors:
Yin Yong,Email:yongyinsd@163 com
Cite this article:
. A dosimetric study of multileaf collimator interdigitation in volumetric modulated arc therapy plans for multiple brain metastases[J]. Chinese Journal of Radiation Oncology, 2016, 25(12): 1319-1322.
. A dosimetric study of multileaf collimator interdigitation in volumetric modulated arc therapy plans for multiple brain metastases[J]. Chinese Journal of Radiation Oncology, 2016, 25(12): 1319-1322.
[1] Matuszak MM,Yan D,Grills I,et al. Clinical applications of volumetric modulated arc therapy[J].Int J Radiat Oncol,2010,77(2):608-616.10.1016/j.ijrobp.2009.08.032.
[2] 刘同海,尹勇,陈进琥,等.鼻咽癌旋转调强与固定野调强同步加量计划比较研究[J].中华放射肿瘤学杂志,2010,19(6):486-490.10.3760/cma.j.issn.1004-4221.2010.06.002.
Liu TH,Yin Y,Chen JH,et al. Comparative study of treatment planning between intensity-modulated arc therapy and simultaneously integrated boost intensity-radiotherapy in nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2010,19(6):486-490.10.3760/cma.j.issn.1004-4221.2010.06.002.
[3] 徐英杰,肖建平,马攀,等.容积调强弧形治疗用于单发脑转移瘤的剂量学研究[J].中华放射肿瘤学杂志,2015,24(3):306-309.10.3760/cma.j.issn.1004-4221.2015.03.019.
Xu YJ,Xiao JP,Ma P,et al. Dosimetry study of volumetric-modulated arc therapy for single brain metastasis[J].Chin J Radiat Oncol,2015,24(3):306-309.10.3760/cma.j.issn.1004-4221.2015.03.019.
[4] Hong CS,Ju SG,Kim M,et al. Dosimetric effects of multileaf collimator leaf width on intensity-modulated radiotherapy for head and neck cancer[J].Med Phys,2014,41(2):021712.10.1118/1.4860155.
[5] van Kesteren Z,Janssen TM,Damen E,et al. The dosimetric impact of leaf interdigitation and leaf width on VMAT treatment planning in Pinnacle:comparing Pareto fronts[J].Phys Med Biol,2012,57(10):2943-2952.10.1088/0031-9155/57/10/2943.
[6] Lafond C,Chajon E,Devillers A,et al. Impact of MLC leaf width on volumetric-modulated arc therapy planning for head and neck cancers[J].J Appl Clin Med Phys,2013,14(6):4074.10.1120/jacmp.v14i6.4074.