[Implementation of cone beam CT-guided volumetric modulated arc therapy and establishment of related institutional...

We intend to present the process of implementation of kilovoltage CT-guided volumetric modulated arc therapy (VMAT), and related quality assurance (QA). An Elekta Synergy™ linear accelerator has been installed recently in our institution, equipped with Agility© head, kilovoltage cone-beam CT image guidance and ability of arc therapy. The major steps of the implementation of these techniques and the background of physics QA will be described. Specific dynamic tests have been performed to verify intensity-modulated radiation delivery and the accuracy of on board imaging. Systematic daily, weekly and monthly physics QA protocols have been worked out and applied in the clinical practice. As a result, cone beam CT based image-guided radiotherapy (IGRT) and volumetric modulated arc therapy was introduced in our institution.