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Related Experiment Video

Updated: Jul 30, 2025

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Noncoplanar Volumetric Modulated Arc Therapy for Hepatocellular Carcinoma Based on a Cage-Like Radiotherapy System: A

Min Ma1, Chuanmeng Niu1, Minghui Li1

  • 1National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Technology in Cancer Research & Treatment
|May 15, 2023
PubMed
Summary

A novel cage-like radiotherapy system improves noncoplanar volumetric modulated arc therapy for liver cancer, significantly reducing radiation dose to normal tissues like the liver, stomach, and lungs compared to other techniques.

Keywords:
cage-like radiotherapycoplanar VMAThepatocellular carcinomanoncoplanar VMAT

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment

Background:

  • Noncoplanar beam arrangements in radiotherapy can spare normal tissues more effectively than coplanar techniques.
  • Existing noncoplanar techniques for hepatocellular carcinoma (HCC) face limitations in effective arc angle due to Linac design, potentially causing collisions.

Purpose of the Study:

  • To introduce and evaluate a novel noncoplanar volumetric modulated arc therapy (VMAT) technique utilizing a cage-like radiotherapy system.
  • To assess the performance of this new technique in patients with hepatocellular carcinoma.

Main Methods:

  • A cage-like radiotherapy system was designed, involving a 90° deflection of the computed tomography.
  • The noncoplanar VMAT technique was planned using the Pinnacle3 system for 10 HCC patients.
  • Dosimetric parameters were compared between the cage-like noncoplanar VMAT, standard noncoplanar VMAT, and conventional VMAT plans.

Main Results:

  • The cage-like noncoplanar VMAT demonstrated statistically significant improvements in planning target volume coverage (D98%, D2%) and plan quality (conformity index, homogeneity index) compared to both standard noncoplanar VMAT and VMAT.
  • This novel technique significantly reduced radiation dose to organs at risk, including the normal liver, stomach, spinal cord, lungs, duodenum, and esophagus.
  • Specific dose reductions were observed for mean liver dose, stomach mean dose, lung V30, spinal cord mean dose, duodenum V50, esophagus maximum dose, and whole lung V30.

Conclusions:

  • The cage-like noncoplanar VMAT technique offers superior dosimetric advantages over standard noncoplanar VMAT and conventional VMAT, particularly in sparing organs at risk.
  • This advanced radiotherapy approach should be considered for treating complex cases of hepatocellular carcinoma.