Skip to main content
Top
Published in: Strahlentherapie und Onkologie 11/2014

01-10-2014 | Original article

Commissioning and first clinical application of mARC treatment

Authors: Dr. rer. nat Yvonne Dzierma, Frank G Nuesken, Stephanie Kremp, Jan Palm, Norbert P Licht, Christian Rübe

Published in: Strahlentherapie und Onkologie | Issue 11/2014

Login to get access

Abstract

Background

The modulated arc (mARC) technique has recently been introduced for Siemens ARTISTE linear accelerators. We present the first experiences with the commissioning of the system and first patient treatments.

Patients and Methods

Treatment planning and delivery are presented for the Prowess Panther treatment planning system or, alternatively, an in-house code. Dosimetric verification is performed both by point dose measurements and in 3D dose distribution.

Results

Depending on the target volume, one or two arcs can be used to create highly conformal plans. Dosimetric verification of the converted mARC plans with step-and-shoot plans shows deviations below 1 % in absolute point dose; in the 3D dose distribution, over 95 % of the points pass the 3D gamma criteria (3 % deviation in local dose and 3 mm distance to agreement for doses > 20 % of the maximum). Patient specific verification of the mARC dose distribution with the calculations has a similar pass rate. Treatment times range between 2 and 5 min for a single arc.

Conclusions

To our knowledge, this is the first report of clinical application of the mARC technique. The mARC offers the possibility to save significant amounts of time, with single-arc treatments of only a few minutes achieving comparable dose distribution to IMRT plans taking up to twice as long.
Literature
1.
go back to reference Alvarez MJ, Kölbl O, Bogner L (2009) Quasi-IMRT study with conventional equipment to show high plan quality with a single gantry arc. Strahlenther Onkol 185:41–48CrossRef Alvarez MJ, Kölbl O, Bogner L (2009) Quasi-IMRT study with conventional equipment to show high plan quality with a single gantry arc. Strahlenther Onkol 185:41–48CrossRef
3.
go back to reference Chan OSH, Lee MCH, Hung AWM, Chang ATY, Yeung RMW, Lee AWM (2011) The superiority of hybrid-volumetric arc therapy (VMAT) technique over double arcs VMAT and 3D-conformal technique in the treatment of locally advanced non-small cell lung cancer—A planning study. Radiother Oncol 101:298–302PubMedCrossRef Chan OSH, Lee MCH, Hung AWM, Chang ATY, Yeung RMW, Lee AWM (2011) The superiority of hybrid-volumetric arc therapy (VMAT) technique over double arcs VMAT and 3D-conformal technique in the treatment of locally advanced non-small cell lung cancer—A planning study. Radiother Oncol 101:298–302PubMedCrossRef
4.
go back to reference Dzierma Y, Licht N, Nuesken F, Ruebe Ch (2012) Beam properties and stability of a flattening-filter-free 7 MV beam—An overview. Med Phys 39:2595–2602PubMedCrossRef Dzierma Y, Licht N, Nuesken F, Ruebe Ch (2012) Beam properties and stability of a flattening-filter-free 7 MV beam—An overview. Med Phys 39:2595–2602PubMedCrossRef
5.
go back to reference Dzierma Y, Nuesken F, Licht N, Ruebe Ch (2013) A novel implementation of mARC planning with automated gantry angle optimization for hybrid fields. Radiat Oncol 8:193PubMedCentralPubMedCrossRef Dzierma Y, Nuesken F, Licht N, Ruebe Ch (2013) A novel implementation of mARC planning with automated gantry angle optimization for hybrid fields. Radiat Oncol 8:193PubMedCentralPubMedCrossRef
6.
go back to reference Fadda G, Massazza G, Zucca S, Durzu S, Meleddu G, Possanzini M, Farace P (2013) Quasi-VMAT in high-grade glioma therapy. Strahlenther Onkol 189:367–371PubMedCrossRef Fadda G, Massazza G, Zucca S, Durzu S, Meleddu G, Possanzini M, Farace P (2013) Quasi-VMAT in high-grade glioma therapy. Strahlenther Onkol 189:367–371PubMedCrossRef
7.
go back to reference Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M (2009) Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes? Radiother Oncol 93:259–265PubMedCrossRef Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M (2009) Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes? Radiother Oncol 93:259–265PubMedCrossRef
8.
go back to reference Kainz K, Chen GP, Chang YW, Prah D, Qi XS, Shukla HP, Stahl J, Li XA (2011) A planning and delivery study of a rotational IMRT technique with burst delivery. Med Phys 38:5104–5118PubMedCrossRef Kainz K, Chen GP, Chang YW, Prah D, Qi XS, Shukla HP, Stahl J, Li XA (2011) A planning and delivery study of a rotational IMRT technique with burst delivery. Med Phys 38:5104–5118PubMedCrossRef
9.
10.
go back to reference Salter BJ, Sarkar V, Wang B, Shukla H, Szegedi M, Rassiah-Szegedi P (2011) Rotational IMRT delivery using a digital linear accelerator in a very high dose rate ‘burst mode’. Phys Med Biol 56:1931–1946PubMedCrossRef Salter BJ, Sarkar V, Wang B, Shukla H, Szegedi M, Rassiah-Szegedi P (2011) Rotational IMRT delivery using a digital linear accelerator in a very high dose rate ‘burst mode’. Phys Med Biol 56:1931–1946PubMedCrossRef
12.
go back to reference Spahn U, Prott FJ (2013) Erste Erfahrungen mit der modulierten Rotationsbestrahlung mARC amd Linearbeschleuniger ARTISTE. Strahlenther Onkol Suppl 1:62–63 Spahn U, Prott FJ (2013) Erste Erfahrungen mit der modulierten Rotationsbestrahlung mARC amd Linearbeschleuniger ARTISTE. Strahlenther Onkol Suppl 1:62–63
13.
go back to reference Teoh M, Clark CH, Wood K, Whitaker S, Nisbet A (2011) Volumetric modulated arc therapy: a review of current literature and clinical use in practice. Brit J Radiol 84:967–996PubMedCentralPubMedCrossRef Teoh M, Clark CH, Wood K, Whitaker S, Nisbet A (2011) Volumetric modulated arc therapy: a review of current literature and clinical use in practice. Brit J Radiol 84:967–996PubMedCentralPubMedCrossRef
14.
go back to reference Vanetti E, Clivio A, Nicolini G, Fogliata A, Ghosh-Laskar S, Agarwal JP, Upreti RR, Budrukkar A, Murthy V, Deshpande DD, Shrivastava SK, Dinshaw KS, Cozzi L (2009) Volumetric modulated arc therapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT. Radiother Oncol 92:111–117PubMedCrossRef Vanetti E, Clivio A, Nicolini G, Fogliata A, Ghosh-Laskar S, Agarwal JP, Upreti RR, Budrukkar A, Murthy V, Deshpande DD, Shrivastava SK, Dinshaw KS, Cozzi L (2009) Volumetric modulated arc therapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT. Radiother Oncol 92:111–117PubMedCrossRef
Metadata
Title
Commissioning and first clinical application of mARC treatment
Authors
Dr. rer. nat Yvonne Dzierma
Frank G Nuesken
Stephanie Kremp
Jan Palm
Norbert P Licht
Christian Rübe
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 11/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-014-0662-9

Other articles of this Issue 11/2014

Strahlentherapie und Onkologie 11/2014 Go to the issue

MITTEILUNGEN DER FACHGESELLSCHAFTEN

Mitteilungen der Fachgesellschaften