| Qiu Jianjian,Lyu Bo,Huang Ying,et al.The feasibility of breath control management guided stereotactic ablation body radiotherapy of liver tumors by volumetric modulated arc therapy[J].Chinese Journal of Radiological Medicine and Protection,2017,37(2):143-148 |
| The feasibility of breath control management guided stereotactic ablation body radiotherapy of liver tumors by volumetric modulated arc therapy |
| Received:September 28, 2016 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.02.011 |
| KeyWords:Volumetric modulated arc therapy (VMAT) Voluntary deep exhale breath hold (vDEBH) Stereotactic ablative body radiotherapy (SABR) Image-guided radiation therapy (IGRT) Liver tumor |
| FundProject: |
| Author Name | Affiliation | E-mail | | Qiu Jianjian | Institute of Radiation Medicine, Fudan University, Shanghai 200032, China | | | Lyu Bo | Department of Radiotherapy, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China | | | Huang Ying | Institute of Radiation Medicine, Fudan University, Shanghai 200032, China | | | Zhuo Weihai | Institute of Radiation Medicine, Fudan University, Shanghai 200032, China | | | Zheng Xiangpeng | Department of Radiotherapy, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China | zhengxp@fudan.edu.cn |
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| Abstract:: |
| Objective To investigate the feasibility and plan quality of the image-guided volumetric modulated arc therapy (VMAT) based voluntary deep exhale breath-holding technique in the stereotactic ablative body radiotherapy (SABR) for liver tumors.Methods Fifteen patients with liver tumors were involved in this study. All patients were immobilized with voluntary deep exhale breath hold (vDEBH) combined with real-time position management (RPM) respiratory gating system. Treatment was planned using VMAT with 2 modified partial arc and re-planned using intensity modulated radiation therapy (IMRT) technique for comparison. Dosimetric parameters were calculated for plan quality assessment. Quality assurance studies included absolute dose and multiple planar dose verifications, total monitor units and delivery time analysis. Daily cone beam computed tomography imaging was used to verify the motions. Results There were no significant dosimetric differences between VMAT and conventional IMRT plans(P>0.05). Both techniques were able to minimize doses to organs at risk including normal liver, kidneys, spinal cord, and stomach. However, the average monitor units with VMAT were significantly lower 28.1% than those with IMRT(t=3.064, P<0.05).The average beam-on time in VMAT plans was 31.6% shorter than that in IMRT plans(t=2.278, P<0.05). Conclusions The utilization of VMAT in the treatment planning of SABR for liver tumors under breath control mode has better dosimetrics. In comparison to conventional IMRT plans, VMAT plans have higher efficiency and feasibility. |
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