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Treating patients with Dynamic Wave Arc: First clinical experience.

Manuela Burghelea1, Dirk Verellen2, Jennifer Dhont3

  • 1Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Department of Radiotherapy, Belgium; Brainlab AG, Feldkirchen, Germany; Babes Bolyai University, Faculty of Physics, Cluj-Napoca, Romania.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|January 25, 2017
PubMed
Summary

Dynamic Wave Arc (DWA) is a novel noncoplanar technique for radiation therapy. This study demonstrates DWA

Keywords:
Clinical implementationDynamic Wave ArcNoncoplanar rotational IMRT

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Technology

Background:

  • Dynamic Wave Arc (DWA) is an advanced noncoplanar rotational radiotherapy technique.
  • It integrates synchronized gantry-ring rotation with dynamic multi-leaf collimator (D-MLC) optimization.

Purpose of the Study:

  • To present the clinical workflow and quality assurance (QA) program for DWA treatments.
  • To report the geometric and dosimetric outcomes from the initial cohort of patients treated with DWA.

Main Methods:

  • Clinical integration of RayStation Treatment Planning System (TPS) on the Vero SBRT platform for DWA.
  • Treatment of 15 patients across diverse sites (breast, prostate, lung, bone metastases).
  • Verification using 3D diode arrays, anthropomorphic phantoms, and orthogonal fluoroscopy for geometric accuracy.

Main Results:

  • Average beam-on delivery time of 3 minutes.
  • All patient QAs met institutional criteria (gamma index).
  • Average agreement between planned and delivered dose distributions exceeded 97% (EBT3 film, Delta4).
  • Mean gantry-ring geometric deviations were within acceptable limits (-0.03°±0.46° and 0.18°±0.26°).

Conclusions:

  • DWA has been successfully implemented clinically for various treatment sites.
  • DWA expands the arsenal of noncoplanar rotational intensity-modulated radiation therapy (IMRT) techniques.
  • It offers enhanced dose shaping flexibility while maintaining dosimetric robustness.