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Strahlentherapie und Onkologie

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29.04.2022 | Original Article

Effect of plan complexity on the dosimetry, delivery accuracy, and interplay effect in lung VMAT SBRT with 6 MV FFF beam

verfasst von: Chao Ge, Huidong Wang, Kunzhi Chen, Wuji Sun, Huicheng Li, Yinghua Shi

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 8/2022

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Abstract

Purpose

The purpose of this study is to investigate the effect of plan complexity on the dosimetry, delivery accuracy, and interplay effect in lung stereotactic body radiation therapy (SBRT) using volumetric modulated arc therapy (VMAT) with 6 MV flattening-filter-free (FFF) beam.

Methods

Twenty patients with early stage non-small cell lung cancer were included. For each patient, high-complexity (HC) and low-complexity (LC) three-partial-arc VMAT plans were optimized by adjusting the normal tissue objectives and the maximum monitoring units (MUs) for a Varian TrueBeam linear accelerator (Varian Medical Systems, Palo Alto, CA, USA) using 6 MV FFF beam. The effect of plan complexity was comprehensively evaluated in three aspects: (1) The dosimetric parameters, including CI, D_2cm, R₅₀, and dose–volume parameters of organs at risk were compared. (2) The delivery accuracy was assessed by pretreatment quality assurance for two groups of plans. (3) The motion-induced dose deviation was evaluated based on point dose measurements near the tumor center by using a programmable phantom. The standard deviation (SD) and maximum dose difference of five measurements were used to quantify the interplay effect.

Results

The dosimetry of HC and LC plans were similar except the CI (1.003 ± 0.032 and 1.026 ± 0.043, p = 0.030) and D_max to the spinal cord (10.6 ± 3.2 and 9.9 ± 3.0, p = 0.012). The gamma passing rates were significantly higher in LC plans for all arcs (p < 0.001). The SDs of HC and LC plans ranged from 0.5–16.6% and 0.03–2.9%, respectively, under the conditions of one-field, two-field, and three-field delivery for each plan with 0.5, 1, 2, and 3 cm motion amplitudes. The maximum dose differences of HC and LC plans were 34.5% and 9.1%, respectively.

Conclusion

For lung VMAT SBRT, LC plans have a higher delivery accuracy and a lower motion-induced dose deviation with similar dosimetry compared with HC plans.

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Rowell NP, Williams CJ (2001) Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable): a systematic review. Thorax 56:628–638. https://doi.org/10.1136/thorax.56.8.628 CrossRefPubMedPubMedCentral

Fakiris AJ, McGarry RC, Yiannoutsos CT et al (2009) Stereotactic body radiation therapy for early-stage non-small-cell lung carcinoma: four-year results of a prospective phase II study. Int J Radiat Oncol Biol Phys 75:677–682. https://doi.org/10.1016/j.ijrobp.2008.11.042 CrossRefPubMed

Nagata Y, Takayama K, Matsuo Y et al (2005) Clinical outcomes of a phase I/II study of 48 Gy of stereotactic body radiotherapy in 4 fractions for primary lung cancer using a stereotactic body frame. Int J Radiat Oncol Biol Phys 63:1427–1431. https://doi.org/10.1016/j.ijrobp.2005.05.034 CrossRefPubMed

Videtic GM, Paulus R, Singh AK et al (2019) Long-term follow-up on NRG oncology RTOG 0915 (NCCTG N0927): a randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer. Int J Radiat Oncol Biol Phys 103:1077–1084. https://doi.org/10.1016/j.ijrobp.2018.11.051 CrossRefPubMed

Li J, Galvin J, Harrison A et al (2012) Dosimetric verification using monte carlo calculations for tissue heterogeneity-corrected conformal treatment plans following RTOG 0813 dosimetric criteria for lung cancer stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 84:508–513. https://doi.org/10.1016/j.ijrobp.2011.12.005 CrossRefPubMedPubMedCentral

Ball D, Mai GT, Vinod S et al (2019) Stereotactic ablative radiotherapy versus standard radiotherapy in stage 1 non-small-cell lung cancer (TROG 09.02 CHISEL): a phase 3, open-label, randomised controlled trial. Lancet Oncol 20:494–503. https://doi.org/10.1016/S1470-2045(18)30896-9 CrossRefPubMed

Ong CL, Dahele M, Slotman BJ et al (2013) Dosimetric impact of the interplay effect during stereotactic lung radiation therapy delivery using flattening filter-free beams and volumetric modulated arc therapy. Int J Radiat Oncol Biol Phys 86:743–748. https://doi.org/10.1016/j.ijrobp.2013.03.038 CrossRefPubMed

Hernandez V, Hansen CR, Widesott L et al (2020) What is plan quality in radiotherapy? The importance of evaluating dose metrics, complexity, and robustness of treatment plans. Radiother Oncol 153:26–33. https://doi.org/10.1016/j.radonc.2020.09.038 CrossRefPubMed

Zhang GG, Ku L, Dilling TJ et al (2011) Volumetric modulated arc planning for lung stereotactic body radiotherapy using conventional and unflattened photon beams: a dosimetric comparison with 3D technique. Radiat Oncol 6:152. https://doi.org/10.1186/1748-717X-6-152 CrossRefPubMedPubMedCentral

10.

Verbakel WF, van den Berg J, Slotman BJ et al (2013) Comparable cell survival between high dose rate flattening filter free and conventional dose rate irradiation. Acta Oncol 52:652–657. https://doi.org/10.3109/0284186X.2012.737021 CrossRefPubMed

11.

Steenken C, Fleckenstein J, Kegel S et al (2015) Impact of flattening-filter-free radiation on the clonogenic survival of astrocytic cell lines. Strahlenther Onkol 191:590–596. https://doi.org/10.1007/s00066-015-0823-5 CrossRefPubMed

12.

Baumann P, Nyman J, Lax I et al (2006) Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries. Acta Oncol 45:787–795. https://doi.org/10.1080/02841860600904862 CrossRefPubMed

13.

Sadrollahi A, Nuesken F, Licht N, Rube C, Dzierma Y (2019) Monte-Carlo simulation of the Siemens Artiste linear accelerator flat 6 MV and flattening-filter-free 7 MV beam line. PLoS ONE 14:e210069. https://doi.org/10.1371/journal.pone.0210069 CrossRefPubMedPubMedCentral

14.

Masi L, Doro R, Favuzza V et al (2013) Impact of plan parameters on the dosimetric accuracy of volumetric modulated arc therapy. Med Phys 40:71718. https://doi.org/10.1118/1.4810969 CrossRefPubMed

15.

Miften M, Olch A, Mihailidis D et al (2018) Tolerance limits and methodologies for IMRT measurement-based verification QA: recommendations of AAPM task group no. 218. Med Phys 45:e53–e83. https://doi.org/10.1002/mp.12810 CrossRefPubMed

16.

Das IJ, Ding GX, Ahnesjo A (2008) Small fields: nonequilibrium radiation dosimetry. Med Phys 35:206–215. https://doi.org/10.1118/1.2815356 CrossRefPubMed

17.

Vieillevigne L, Khamphan C, Saez J et al (2019) On the need for tuning the dosimetric leaf gap for stereotactic treatment plans in the Eclipse treatment planning system. J Appl Clin Med Phys 20:68–77. https://doi.org/10.1002/acm2.12656 CrossRefPubMedPubMedCentral

18.

Nguyen M, Chan GH (2020) Quantified VMAT plan complexity in relation to measurement-based quality assurance results. J Appl Clin Med Phys 21:132–140. https://doi.org/10.1002/acm2.13048 CrossRefPubMedPubMedCentral

19.

Ong CL, Verbakel WF, Cuijpers JP et al (2011) Dosimetric impact of interplay effect on RapidArc lung stereotactic treatment delivery. Int J Radiat Oncol Biol Phys 79:305–311. https://doi.org/10.1016/j.ijrobp.2010.02.059 CrossRefPubMed

20.

Sande EPS, Acosta Roa AM, Hellebust TP (2020) Dose deviations induced by respiratory motion for radiotherapy of lung tumors: impact of CT reconstruction, plan complexity, and fraction size. J Appl Clin Med Phys 21:68–79. https://doi.org/10.1002/acm2.12847 CrossRefPubMedPubMedCentral

21.

Burton A, Offer K, Hardcastle N (2020) A robust VMAT delivery solution for single-fraction lung SABR utilizing FFF beams minimizing dosimetric compromise. J Appl Clin Med Phys 21:299–304. https://doi.org/10.1002/acm2.12919 CrossRefPubMedPubMedCentral

22.

Riley C, Yang Y, Li T et al (2014) Dosimetric evaluation of the interplay effect in respiratory-gated RapidArc radiation therapy. Med Phys 41:11715. https://doi.org/10.1118/1.4855956 CrossRefPubMed

23.

Edvardsson A, Scherman J, Nilsson MP et al (2019) Breathing-motion induced interplay effects for stereotactic body radiotherapy of liver tumours using flattening-filter free volumetric modulated arc therapy. Phys Med Biol 64:25006. https://doi.org/10.1088/1361-6560/aaf5d9 CrossRefPubMed

24.

Li G, Jiang W, Li Y et al (2021) Description and evaluation of a new volumetric-modulated arc therapy plan complexity metric. Med Dosim 46:188–194. https://doi.org/10.1016/j.meddos.2020.11.004 CrossRefPubMed

25.

Fernandez DJ, Sick JT, Fontenot JD (2020) Interplay effects in highly modulated stereotactic body radiation therapy lung cases treated with volumetric modulated arc therapy. J Appl Clin Med Phys 21:58–69. https://doi.org/10.1002/acm2.13028 CrossRefPubMedPubMedCentral

26.

ICRU (2014) ICRU report 91: prescribing, recording, and reporting of stereotactic treatments with small photon beams. J Int Comm Radiat Units Meas 14(2):1–145

27.

Low DA, Harms WB, Mutic S et al (1998) A technique for the quantitative evaluation of dose distributions. Med Phys 25:656–661. https://doi.org/10.1118/1.598248 CrossRefPubMed

28.

Du W, Cho SH, Zhang X et al (2014) Quantification of beam complexity in intensity-modulated radiation therapy treatment plans. Med Phys 41:21716. https://doi.org/10.1118/1.4861821 CrossRefPubMed

29.

Wang Y, Pang X, Feng L et al (2018) Correlation between gamma passing rate and complexity of IMRT plan due to MLC position errors. Phys Med 47:112–120. https://doi.org/10.1016/j.ejmp.2018.03.003 CrossRefPubMed

30.

Rangel A, Dunscombe P (2009) Tolerances on MLC leaf position accuracy for IMRT delivery with a dynamic MLC. Med Phys 36:3304–3309. https://doi.org/10.1118/1.3134244 CrossRefPubMed

31.

Jiang SB, Pope C, Al Jarrah KM et al (2003) An experimental investigation on intra-fractional organ motion effects in lung IMRT treatments. Phys Med Biol 48:1773–1784. https://doi.org/10.1088/0031-9155/48/12/307 CrossRefPubMed

32.

Schwarz M, Cattaneo GM, Marrazzo L (2017) Geometrical and dosimetrical uncertainties in hypofractionated radiotherapy of the lung: a review. Phys Med 36:126–139. https://doi.org/10.1016/j.ejmp.2017.02.011 CrossRefPubMed

33.

Bortfeld T, Jiang SB, Rietzel E (2004) Effects of motion on the total dose distribution. Semin Radiat Oncol 14:41–51. https://doi.org/10.1053/j.semradonc.2003.10.011 CrossRefPubMed

34.

Bortfeld T, Jokivarsi K, Goitein M et al (2002) Effects of intra-fraction motion on IMRT dose delivery: statistical analysis and simulation. Phys Med Biol 47:2203–2220. https://doi.org/10.1088/0031-9155/47/13/302 CrossRefPubMed

35.

Rao M, Wu J, Cao D et al (2012) Dosimetric impact of breathing motion in lung stereotactic body radiotherapy treatment using intensity modulated radiotherapy and volumetric modulated arc therapy. Int J Radiat Oncol Biol Phys 83:e251–e256. https://doi.org/10.1016/j.ijrobp.2011.12.001 CrossRefPubMed

36.

Keall PJ, Mageras GS, Balter JM et al (2006) The management of respiratory motion in radiation oncology report of AAPM task group 76. Med Phys 33:3874–3900. https://doi.org/10.1118/1.2349696 CrossRefPubMed

Titel: Effect of plan complexity on the dosimetry, delivery accuracy, and interplay effect in lung VMAT SBRT with 6 MV FFF beam
verfasst von: Chao Ge
Huidong Wang
Kunzhi Chen
Wuji Sun
Huicheng Li
Yinghua Shi
Publikationsdatum: 29.04.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 8/2022
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-01940-3

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Effect of plan complexity on the dosimetry, delivery accuracy, and interplay effect in lung VMAT SBRT with 6 MV FFF beam

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Methods

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