Radiotherapy of malignant gliomas: comparison of volumetric single arc technique (RapidArc), dynamic intensity-modulated technique and 3D conformal technique.

PURPOSE The analysis was designed to identify the optimal radiation technique for patients with malignant glioma. METHODS A volumetric-modulated radiation treatment technique (RapidArc), an IMRT technique and a 3D conformal technique were calculated on computed tomograms of 14 consecutive patients with malignant glioma. The treatment plans were compared with each other using dose-volume histograms. RESULTS The 3D conformal technique showed a good PTV coverage, if PTV was distant to organs at risk (OAR). If PTV was nearby OAR, the 3D technique revealed a poor PTV coverage in contrast to both intensity-modulated techniques. The conventional IMRT technique showed a slightly better PTV coverage than RapidArc. The advantages of RapidArc were a shorter treatment time, less monitor units and a small V(107%). CONCLUSIONS If PTV is distant to OAR, the use of 3D conformal technique is sufficient. Otherwise an intensity-modulated technique should be used. RapidArc was faster than conventional IMRT and should be preferred if PTV coverage is adequate.

[1]  L. Bogner,et al.  Quasi-IMAT Technique and Secondary Cancer Risk in Prostate Cancer , 2009, Strahlentherapie und Onkologie.

[2]  H. Vorwerk,et al.  Impact of different leaf velocities and dose rates on the number of monitor units and the dose-volume-histograms using intensity modulated radiotherapy with sliding-window technique , 2008, Radiation oncology.

[3]  L. Cozzi,et al.  A planning comparison of dose patterns in organs at risk and predicted risk for radiation induced malignancy in the contralateral breast following radiation therapy of primary breast using conventional, IMRT and Volumetric modulated arc treatment techniques , 2009, Acta oncologica.

[4]  Luca Cozzi,et al.  Intensity modulation with photons for benign intracranial tumours: a planning comparison of volumetric single arc, helical arc and fixed gantry techniques. , 2008, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[5]  M. Goitein,et al.  Tolerance of normal tissue to therapeutic irradiation. , 1991, International journal of radiation oncology, biology, physics.

[6]  U. Schneider,et al.  Effect of intensity-modulated pelvic radiotherapy on second cancer risk in the postoperative treatment of endometrial and cervical cancer. , 2009, International journal of radiation oncology, biology, physics.

[7]  J. Debus,et al.  Radiochemotherapy in patients with primary glioblastoma comparing two temozolomide dose regimens. , 2008, International journal of radiation oncology, biology, physics.

[8]  K Otto,et al.  Volumetric modulated Arc therapy and conventional intensity-modulated radiotherapy for simultaneous maximal intraprostatic boost: a planning comparison study. , 2009, Clinical oncology (Royal College of Radiologists (Great Britain)).

[9]  Luca Cozzi,et al.  A treatment planning study comparing volumetric arc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy. , 2008, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[10]  S. Zavgorodni,et al.  A Monte Carlo evaluation of RapidArc dose calculations for oropharynx radiotherapy , 2008, Physics in medicine and biology.

[11]  Andrew K. Lee,et al.  Risk of secondary malignant neoplasms from proton therapy and intensity-modulated x-ray therapy for early-stage prostate cancer. , 2009, International journal of radiation oncology, biology, physics.

[12]  Karl Otto,et al.  Volumetric modulated arc therapy: IMRT in a single gantry arc. , 2007, Medical physics.

[13]  Stine Korreman,et al.  RapidArc volumetric modulated therapy planning for prostate cancer patients , 2009, Acta oncologica.

[14]  Luca Cozzi,et al.  Volumetric modulated arc radiotherapy for carcinomas of the oro-pharynx, hypo-pharynx and larynx: a treatment planning comparison with fixed field IMRT. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[15]  D. Low,et al.  A technique for the quantitative evaluation of dose distributions. , 1998, Medical physics.

[16]  R. Mirimanoff,et al.  Radiotherapy and temozolomide for newly diagnosed glioblastoma: recursive partitioning analysis of the EORTC 26981/22981-NCIC CE3 phase III randomized trial. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  C. Ling,et al.  Commissioning and quality assurance of RapidArc radiotherapy delivery system. , 2008, International journal of radiation oncology, biology, physics.

[18]  Dietrich Harder,et al.  A Triple Gaussian Pencil beam Model for Photon beam Treatment Planning , 1995 .

[19]  Luca Cozzi,et al.  Volumetric-modulated arc radiotherapy for carcinomas of the anal canal: A treatment planning comparison with fixed field IMRT. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[20]  K Bush,et al.  Monte Carlo simulation of RapidArc radiotherapy delivery , 2008, Physics in medicine and biology.