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DMLC tracking and gating can improve dose coverage for prostate VMAT.

E Colvill1, P R Poulsen2, J T Booth3

  • 1Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW 2065, Australia; and School of Physics, University of Sydney, NSW 2006, Australia.

Medical Physics
|September 5, 2014
PubMed
Summary
This summary is machine-generated.

Dynamic multileaf collimator (DMLC) tracking and gating effectively correct intrafraction motion in prostate radiotherapy. Both methods ensure robust dose distributions, significantly improving target coverage compared to no motion correction.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment

Background:

  • Intrafraction motion significantly impacts dose delivery accuracy in prostate radiotherapy.
  • Conventionally fractionated radiotherapy requires precise dose coverage for optimal outcomes.
  • Motion correction strategies are crucial for mitigating intrafraction motion effects.

Purpose of the Study:

  • To compare the dosimetric impact of dynamic multileaf collimator (DMLC) tracking and gating for intrafraction motion management.
  • To assess the effectiveness of these strategies against uncorrected motion during prostate radiotherapy.

Main Methods:

  • Retrospective dose reconstruction of 20 volumetric modulated arc therapy fractions from five prostate cancer patients.
  • Simulation of DMLC tracking using Linac log files and gating with a 3 mm threshold for 5 seconds.
  • Comparison of delivered, DMLC tracking, and gating dose distributions with planned values.

Main Results:

  • Intrafraction motion caused substantial dose decreases (up to 19% for CTVD99%, 34% for PTV D95%) in some fractions without correction.
  • Both DMLC tracking and gating improved CTV D99% to within 4% of planned values for all fractions.
  • DMLC tracking reduced maximum rectum and bladder V65% differences to 6% and 4%, respectively.

Conclusions:

  • DMLC tracking and gating are effective in managing intrafraction motion during prostate radiotherapy.
  • These motion correction techniques ensure robust dose distributions, maintaining target coverage.
  • While uncorrected motion can impact some fractions, overall treatment is likely unaffected for most patients.