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Plan-Optimization Method for Central-shielding Pelvic Volumetric-modulated Arc Therapy for Cervical Cancer
Ryuta Hirai1, Tomoaki Tamaki2,3, Mitsunobu Igari2
1Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama, Japan rhirai@saitama-med.ac.jp.
In Vivo (Athens, Greece)
|November 4, 2020
Summary
This study introduces an optimized volumetric-modulated arc therapy (VMAT) plan for cervical cancer using central shielding (CS). The optimized VMAT plan significantly reduces rectal dose while maintaining target coverage, comparable to 3DCRT.
Area of Science:
- Radiation Oncology
- Medical Physics
- Gynecologic Oncology
Background:
- Cervical cancer treatment often involves radiation therapy.
- Volumetric-modulated arc therapy (VMAT) is a modern radiotherapy technique.
- Central shielding (CS) is a principle used to reduce dose to organs at risk.
Purpose of the Study:
- To develop and evaluate an optimized VMAT planning method for cervical cancer incorporating the central shielding (CS) principle.
- To assess the dosimetric impact of this optimization on organs at risk, particularly the rectum.
Main Methods:
- External beam VMAT plans were created for eight cervical cancer patients (Stage I-IIb) using the CS principle.
- Clinical target volumes (CTVs) were defined according to established guidelines.
- A specific planning target volume (Ant-Rectum) was defined for dose optimization.
- Two VMAT plans were compared: one with dose optimization to the Ant-Rectum (VMAT_OPT) and one without (VMAT_NO).
Main Results:
- VMAT_OPT plans demonstrated significantly lower dose-volume histogram (DVH) parameters for the Ant-Rectum and rectum compared to VMAT_NO plans.
- The dosimetric outcomes of VMAT_OPT were comparable to those of traditional 3D conformal radiotherapy (3DCRT).
- Both VMAT plans achieved superior planning target volume coverage compared to 3DCRT.
Conclusions:
- The developed optimization method is crucial for maximizing the benefits of the CS principle in VMAT for cervical cancer.
- This approach represents a significant advancement for implementing intensity-modulated radiation therapy (IMRT)/VMAT as a standard treatment in Japan.
