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An institutional review: dosimetry comparison between simultaneous integrated boost IMRT and VMAT for prostate cancer

Published online by Cambridge University Press:  09 June 2020

Raheel Mukhtar Open the ORCID record for Raheel Mukhtar [Opens in a new window] ,
Sumera Butt ,
Muhammad Abdur Rafaye ,
Khalid Iqbal ,
Sana Mazhar  and
Tabinda Sadaf
Raheel Mukhtar
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Sumera Butt
Affiliation:
Clinical and Radiation Oncology Department, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Muhammad Abdur Rafaye
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Khalid Iqbal*
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Sana Mazhar
Affiliation:
Department of Medical Physics, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
Tabinda Sadaf
Affiliation:
Clinical and Radiation Oncology Department, ShaukatKhanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
*
Author for correspondence: Khalid Iqbal, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A BLOCK R-3 MA, Johar Town Lahore, Lahore, Punjab54000, Pakistan. Tel: +00923006333815. E-mail: kiqbal@skm.org.pk
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Abstract

Purpose:

A comparative study was performed about the plan parameters and quality indices between volumetric arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) for the treatment of high-risk prostate cancer patients. The aim of this retrospective study was to compare the two methods of external beam radiotherapy IMRT and VMAT in terms of plan quality and efficacy.

Material and method:

Fifteen high-risk prostate patients were planned for radiotherapy using 6 MV photon. Three dose levels were contoured having Planning Tumour Volume 1 (PTV1 = 48 Gy), Planning Tumour Volume 2 (PTV2 = 57.6 Gy) and Planning Tumour Volume 3 (PTV3 = 60 Gy). Setup margins were given using the CHIP trial method. The prescribed PTV3 dose was 60 Gy in 20 fractions which is biologically equivalent to 74 Gy in 37 fractions using α/β = 3. In case of IMRT, seven fixed beam angles 30, 60, 105, 180, 255, 300 and 330 were used and the dose was optimised using the sliding window method. In case of rapid arc technique, one or two full arcs were used for dose optimisation while keeping all the dose constraints and other planning parameters same used in IMRT. The plan evaluation parameters and Organ at risks (OARs) doses were calculated using a dose volume histogram (DVH).

Results:

The average D2, D5, D95 and PTVmean for PTV3 were 61.22, 61.13, 58.12, 60.00 Gy and 62.41 62.24 59.53 61.12 Gy for IMRT and VMAT, respectively. The averages V60 for bladder and V30 for rectum were 22.81, 25 and 67, 65% for IMRT and VMAT, respectively. The average homogeneity index (HI), conformity index (CI) and gradient index (GI) were 1.04, 1.4833, 14.79 and 1.04, 1.704, 7.89 for IMRT and VMAT, respectively.

Conclusion:

VMAT takes less dose-delivery time and lesser number of monitoring units than IMRT, thus it compensates the intrafractional movements during dose delivery. The Dose GI in VMAT was much better than IMRT. This indicates sharper dose fall off near the normal tissue. No other major differences were observed in terms of plan evaluation parameters between IMRT and VMAT techniques. So, we conclude that VMAT technique is more efficient than IMRT in terms of plan quality and dose delivery.

Keywords

conformity indexgradient indexhomogeneity indexintensity-modulated radiotherapyvolumetric arc therapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 321 - 331
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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