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Radiation Oncology

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Open Access 01-12-2010 | Research

Feasibility study of volumetric modulated arc therapy for the treatment of retroperitoneal sarcomas

Authors: Carmen Llacer-Moscardo, François Quenet, David Azria, Pascal Fenoglietto

Published in: Radiation Oncology | Issue 1/2010

Abstract

Background

Radiotherapy for retroperitoneal sarcomas remains controversial and a technical challenge considering the threshold of contiguous critical organs tolerance. We performed consecutive RapidArc dosimetric plans in preoperative or postoperative setting.

Methods

A dosimetric study was carried out from six preoperative (group A) and four postoperative (group B) CT-scans, performed in 7 patients.

Prescribed dose was 45 and 50 Gy for groups A and B, respectively. The planning target volume (PTV) was defined as the clinical target volume (CTV) plus 5 mm. The CTV encompassed the gross tumor volume (GTV) plus 10 mm or the tumoral bed. The dosimetric plans were optimized on a RapidArc Eclipse console using the progressive resolution algorithm, PRO version 8.8. Normalization method allowed the coverage of 99% of the PTV by 95% of the dose.

Results

Mean PTV were 2318.5 ± 2223.9 cc [range 348-6198 cc] and 698.3 ± 216.6 cc [range 463 -933 cc] for groups A and B, respectively. Plans were optimized for single arcs in group B and for single or two arcs in group A. The contralateral kidney volume receiving 5 Gy (V_5Gy) was 21.5 ± 23.3% [range 0-55%] and 3.1 ± 2.6% [range 0-7.3%] for groups A and B, respectively. The mean dose received by 1% of the kidney (D_1%) was 5.6 ± 2.4 Gy [range 3.6 -7.6 Gy] for group A and 5.4 ± 0.7 Gy [range 4.3-6 Gy] for group B. The volume of small bowel excluding the PTV (small bowel-PTV) that received 40 Gy and 30 Gy (V_40Gy and V_30Gy) in group A were 7.5 ± 4.4% [range 5.4-14.1%] and 18.5 ± 7.1% [range 10-30.4%], respectively.

In group B, small bowel-PTV V_40Gy and V_30Gy were 4.7 ± 3.3% [range 3.3-8%] and 21.6 ± 7.5% [range 9.4-30%] respectively. In a second step, we treated two patients in the postoperative group. Treatment time delivery with one arc was 74 seconds. No severe acute toxicity was observed.

Conclusion

RapidArc technology for retroperitoneal sarcomas showed acceptable dosimetric results in preoperative or postoperative clinical situation. From the first treated patients, acute tolerability was good to excellent.

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Title: Feasibility study of volumetric modulated arc therapy for the treatment of retroperitoneal sarcomas
Authors: Carmen Llacer-Moscardo
François Quenet
David Azria
Pascal Fenoglietto
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2010
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-5-83

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Feasibility study of volumetric modulated arc therapy for the treatment of retroperitoneal sarcomas

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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