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Feasibility Study of 3D-VMAT-Based GRID Therapy.

Xin Zhang1,2, Robert J Griffin2, Edvaldo P Galhardo2,3

  • 1Department of Radiation Oncology, Boston Medical Center, 1836Boston University School of Medicine, Boston, MA, USA.

Technology in Cancer Research & Treatment
|March 15, 2022
PubMed
Summary
This summary is machine-generated.

This study introduces a novel volumetric modulated arc therapy with a virtual GRID block (VMAT-GRID) technique for advanced tumors. The VMAT-GRID approach successfully delivers radiotherapy with favorable dose metrics while sparing surrounding normal tissues.

Keywords:
dosimetryspatially fractionated radiotherapyvirtual GRID blockvolumetric modulated arc therapy

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment

Background:

  • Spatially fractionated radiotherapy (GRID) is effective for debulking shallow and deep-seated locally advanced tumors.
  • A novel treatment planning method, volumetric modulated arc therapy with a virtual GRID block (VMAT-GRID), was developed to improve plan conformity while maintaining GRID's dosimetric characteristics.

Purpose of the Study:

  • To evaluate the dosimetric characteristics and feasibility of the VMAT-GRID technique for treating locally advanced tumors.
  • To assess the ability of VMAT-GRID to deliver prescribed doses while sparing organs at risk.

Main Methods:

  • Retrospective study of 25 patients with tumor volumes ranging from 71.6 cc to 4683 cc.
  • VMAT-GRID plans were generated using 6 MV/10 MV flattening-filter-free beams with a prescription of 20 Gy to the gross tumor volume (GTV) in a single fraction.
  • Dosimetric metrics including valley/peak ratio (Dmin/Dmax), D90/D10, GTV mean dose (Dmean), GTV equivalent uniform dose (EUD), and normal tissue maximum dose were calculated.

Main Results:

  • The optimized virtual GRID block (VGB) had a median center-to-center distance of 27 mm and a median opening diameter of 9 mm.
  • Median GTV mean dose was 918 cGy and median GTV EUD was 818 cGy.
  • Median valley-to-peak dose ratio was 0.07, and median D90/D10 was 0.70, indicating acceptable dose inhomogeneity. Rapid dose fall-off was observed in normal tissues adjacent to the GTV.

Conclusions:

  • The VMAT-GRID planning approach can successfully deliver radiotherapy with acceptable GRID dose metrics.
  • This technique effectively spares normal tissues, particularly those near the target, due to rapid dose fall-off and confinement of the maximum dose within the GTV.