Critical Appraisal of Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Metastases to Abdominal Lymph Nodes

Mario Bignardi, Luca Cozzi, Antonella Fogliata, Paola Lattuada, Pietro Mancosu, Piera Navarria, Gaetano Urso, Sabrina Vigorito, Marta Scorsetti

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Purpose: A planning study was performed comparing volumetric modulated arcs, RapidArc (RA), fixed beam IMRT (IM), and conformal radiotherapy (CRT) with multiple static fields or short conformal arcs in a series of patients treated with hypofractionated stereotactic body radiation therapy (SBRT) for solitary or oligo-metastases from different tumors to abdominal lymph nodes. Methods and Materials: Fourteen patients were included in the study. Dose prescription was set to 45 Gy (mean dose to clinical target volume [CTV]) in six fractions of 7.5 Gy. Objectives for CTV and planning target volume (PTV) were as follows: Dosemin >95%, Dosemax 15Gy 36Gy 36Gy 15Gy 3) for liver. Dose-volume histograms were evaluated to assess plan quality. Results: Planning objectives on CTV and PTV were achieved by all techniques. Use of RA improved PTV coverage (V95% = 90.2% ± 5.2% for RA compared with 82.5% ± 9.6% and 84.5% ± 8.2% for CRT and IM, respectively). Most planning objectives for organs at risk were met by all techniques except for the duodenum, small bowel, and stomach, in which the CRT plans exceeded the dose/volume constraints in some patients. The MU/fraction values were as follows: 2186 ± 211 for RA, 2583 ± 699 for IM, and 1554 ± 153 for CRT. Effective treatment time resulted as follows: 3.7 ± 0.4 min for RA, 10.6 ± 1.2 min for IM, and 6.3 ± 0.5 min for CRT. Conclusions: Delivery of SBRT by RA showed improvements in conformal avoidance with respect to standard conformal irradiation. Delivery parameters confirmed logistical advantages of RA, particularly compared with IM.

Original languageEnglish
Pages (from-to)1570-1577
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume75
Issue number5
DOIs
Publication statusPublished - Dec 1 2009

Fingerprint

Conformal Radiotherapy
Intensity-Modulated Radiotherapy
lymphatic system
metastasis
radiation therapy
therapy
Radiotherapy
arcs
Lymph Nodes
Neoplasm Metastasis
planning
dosage
Organs at Risk
delivery
Duodenum
Prescriptions
Stomach
stomach
avoidance
liver

Keywords

  • IMRT
  • RapidArc
  • Stereotactic body radiation therapy
  • Volumetric modulated arc therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Critical Appraisal of Volumetric Modulated Arc Therapy in Stereotactic Body Radiation Therapy for Metastases to Abdominal Lymph Nodes. / Bignardi, Mario; Cozzi, Luca; Fogliata, Antonella; Lattuada, Paola; Mancosu, Pietro; Navarria, Piera; Urso, Gaetano; Vigorito, Sabrina; Scorsetti, Marta.

In: International Journal of Radiation Oncology Biology Physics, Vol. 75, No. 5, 01.12.2009, p. 1570-1577.

Research output: Contribution to journalArticle

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AU - Lattuada, Paola

AU - Mancosu, Pietro

AU - Navarria, Piera

AU - Urso, Gaetano

AU - Vigorito, Sabrina

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