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Open Access 01-12-2010 | Research

Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

Authors: Umesh Mahantshetty, Swamidas Jamema, Reena Engineer, Deepak Deshpande, Rajiv Sarin, Antonella Fogliata, Giorgia Nicolini, Alessandro Clivio, Eugenio Vanetti, Shyamkishore Shrivastava, Luca Cozzi

Published in: Radiation Oncology | Issue 1/2010

Abstract

Purpose

A study was performed to assess dosimetric characteristics of volumetric modulated arcs (RapidArc, RA) and fixed field intensity modulated therapy (IMRT) for Whole Abdomen Radiotherapy (WAR) after ovarian cancer.

Methods and Materials

Plans for IMRT and RA were optimised for 5 patients prescribing 25 Gy to the whole abdomen (PTV_WAR) and 45 Gy to the pelvis and pelvic nodes (PTV_Pelvis) with Simultaneous Integrated Boost (SIB) technique. Plans were investigated for 6 MV (RA6, IMRT6) and 15 MV (RA15, IMRT15) photons. Objectives were: for both PTVs V_90% > 95%, for PTV_Pelvis: D_max < 105%; for organs at risk, maximal sparing was required. The MU and delivery time measured treatment efficiency. Pre-treatment Quality assurance was scored with Gamma Agreement Index (GAI) with 3% and 3 mm thresholds.

Results

IMRT and RapidArc resulted comparable for target coverage. For PTV_WAR, V_90% was 99.8 ± 0.2% and 93.4 ± 7.3% for IMRT6 and IMRT15, and 98.4 ± 1.7 and 98.6 ± 0.9% for RA6 and RA15. Target coverage resulted improved for PTV_Pelvis. Dose homogeneity resulted slightly improved by RA (Uniformity was defined as U_5-95% = D_5%-D_95%/D_mean). U₅-_95% for PTV_WAR was 0.34 ± 0.05 and 0.32 ± 0.06 (IMRT6 and IMRT15), 0.30 ± 0.03 and 0.26 ± 0.04 (RA6 and RA15); for PTV_Pelvis, it resulted equal to 0.1 for all techniques. For organs at risk, small differences were observed between the techniques. MU resulted 3130 ± 221 (IMRT6), 2841 ± 318 (IMRT15), 538 ± 29 (RA6), 635 ± 139 (RA15); the average measured treatment time was 18.0 ± 0.8 and 17.4 ± 2.2 minutes (IMRT6 and IMRT15) and 4.8 ± 0.2 (RA6 and RA15). GAI_IMRT6 = 97.3 ± 2.6%, GAI_IMRT15 = 94.4 ± 2.1%, GAI_RA6 = 98.7 ± 1.0% and GAI_RA15 = 95.7 ± 3.7%.

Conclusion

RapidArc showed to be a solution to WAR treatments offering good dosimetric features with significant logistic improvements compared to IMRT.

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Title: Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation
Authors: Umesh Mahantshetty
Swamidas Jamema
Reena Engineer
Deepak Deshpande
Rajiv Sarin
Antonella Fogliata
Giorgia Nicolini
Alessandro Clivio
Eugenio Vanetti
Shyamkishore Shrivastava
Luca Cozzi
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-5-106

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Whole abdomen radiation therapy in ovarian cancers: a comparison between fixed beam and volumetric arc based intensity modulation

Abstract

Purpose

Methods and Materials

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods and Materials

Results

Conclusion

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