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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Dose comparisons for conformal, IMRT and VMAT prostate plans.

Charlotte Sale¹, Phillip Moloney

¹Andrew Love Cancer Centre, Geelong Hospital, Geelong, Victoria, Australia. csale@barwonhealth.org.au

Journal of Medical Imaging and Radiation Oncology

|December 7, 2011

Summary

Volumetric-modulated arc therapy (VMAT) offers favorable dosimetry for prostate cancer treatment compared to intensity-modulated radiation therapy (IMRT) and conformal plans. Both single- and double-arc VMAT provide superior critical tissue sparing, with double-arc VMAT showing optimal results.

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Area of Science:

Radiation Oncology
Medical Physics

Background:

Volumetric-modulated arc therapy (VMAT) is an advanced radiation technique.
Comparing VMAT with intensity-modulated radiation therapy (IMRT) and conformal therapy is crucial for prostate cancer treatment optimization.

Purpose of the Study:

To compare the dosimetric impact of single- and double-arc VMAT with IMRT and conformal plans in prostate cancer cases.
To evaluate if VMAT increases the volume of bowel receiving lower doses.
To determine the optimal number of VMAT arcs for standard prostate cases.

Main Methods:

Eight prostate cancer patients were selected for dosimetric evaluation.
Conformal, IMRT, and single/double-arc VMAT plans were generated.
All plans delivered 75.6 Gy over 42 fractions to the planning target volume (PTV).

Main Results:

IMRT and double-arc VMAT demonstrated superior PTV dosimetry compared to conformal plans.
Single-arc VMAT resulted in a higher maximum PTV dose than conformal or double-arc VMAT.
No significant differences in bladder and small bowel dosimetry were observed across techniques.
IMRT and VMAT plans reduced radiation to the rectum and femoral heads.

Conclusions:

Single- and double-arc VMAT consistently provided favorable or superior dosimetry compared to static-gantry IMRT for prostate cases.
Both VMAT techniques and IMRT offered superior critical tissue sparing over conformal plans.
Double-arc VMAT and IMRT were optimal for left femoral head sparing, while single-arc VMAT was optimal for the right femoral head.