Impact of MLC leaf width on volumetric‐modulated arc therapy planning for head and neck cancers
This dosimetric study investigated the impact of multileaf collimators (MLC) leaf width in volumetric‐modulated arc therapy (VMAT) for head and neck cancers (HNC), either with a “standard” simultaneously integrated boost technique (S‐SIB) or with a “dose painting” SIB technique (DP‐SIB). HNC patient...
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| creator | Lafond, Caroline Chajon, Enrique Devillers, Anne Louvel, Guillaume Toublanc, Sandra Olivier, Mickael Simon, Antoine Crevoisier, Renaud Manens, Jean‐Pierre |
| description | This dosimetric study investigated the impact of multileaf collimators (MLC) leaf width in volumetric‐modulated arc therapy (VMAT) for head and neck cancers (HNC), either with a “standard” simultaneously integrated boost technique (S‐SIB) or with a “dose painting” SIB technique (DP‐SIB). HNC patients were planned either with an S‐SIB comprising three dose levels, from 56 to 70 Gy (16 patients), or with a DP‐SIB comprising five dose levels, from 56 to 84 Gy (8 patients), in 35 fractions. Two VMAT plans were calculated for each SIB technique using two Elekta MLCs: MLCi2 with 10 mm leaf width and Beam Modulator (BM) with 4 mm leaf width. Dose distributions were evaluated by comparing doses on PTVs, main OARs, and healthy tissue, and by comparing conformation indexes. Treatment efficiencies were evaluated by comparing the number of monitor units and the number of needed arcs. Comparisons of the two MLCs depending on the two SIB techniques showed: i) Regarding PTVs: Dmean and D2% on lower doses PTV decreased respectively by 0.5 Gy (p=0.01) and 0.9 Gy (p=0.01) with BM than with MLCi2 for S‐SIB; no significant difference was found for DP‐SIB; ii) Regarding OARs: for spinal cord and brainstem, D2% decreased respectively by 1.2 Gy (p=0.03) and 4.2 Gy (p=0.04) with BM than with MLCi2 for S‐SIB; for controlateral parotid, D50% decreased by 1.5 Gy (p=0.01) with BM than with MLCi2 for S‐SIB; iii) Regarding treatment efficiency : the number of monitor units was 44% (p=0.00) and 51% (p=0.01) higher with BM for S‐SIB and DP‐SIB, respectively. Two arcs were more frequently needed with BM to reach an acceptable dose distribution. This study demonstrated that Beam Modulator (4 mm leaf width) and MLCi2 (10 mm leaf width) MLCs from Elekta provided satisfactory dose distributions for treatment delivery with VMAT technique for complex HNC cases with standard and dose painting prescriptions. OAR sparing was better with BM, mainly for brainstem and spinal cord. However, delivery efficiency of VMAT plans was better with MLCi2.
PACS numbers: 87.56.N‐, 87.56.nk, 87.55.D‐ |
| doi_str_mv | 10.1120/jacmp.v14i6.4074 |
| format | Article |
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PACS numbers: 87.56.N‐, 87.56.nk, 87.55.D‐</description><identifier>ISSN: 1526-9914</identifier><identifier>EISSN: 1526-9914</identifier><identifier>DOI: 10.1120/jacmp.v14i6.4074</identifier><identifier>PMID: 24257269</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Advantages ; Cancer therapies ; Dosimetry ; Efficiency ; Head & neck cancer ; head and neck cancer ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - radiotherapy ; Humans ; leaf width ; multileaf collimators ; Neoplasm Staging ; Optimization ; Planning ; Plant growth ; Prescriptions ; Prognosis ; Radiation Oncology Physics ; Radiation therapy ; Radiometry - instrumentation ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated ; Spinal cord ; Studies ; Tomography, X-Ray Computed ; VMAT</subject><ispartof>Journal of applied clinical medical physics, 2013-11, Vol.14 (6), p.40-52</ispartof><rights>2013 The Authors.</rights><rights>2013. This work is published under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6070-114b693987b2006ba348322dc9684e689b8e03e9662a6e96f8223e0300a2d0e53</citedby><cites>FETCH-LOGICAL-c6070-114b693987b2006ba348322dc9684e689b8e03e9662a6e96f8223e0300a2d0e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714620/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714620/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24257269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lafond, Caroline</creatorcontrib><creatorcontrib>Chajon, Enrique</creatorcontrib><creatorcontrib>Devillers, Anne</creatorcontrib><creatorcontrib>Louvel, Guillaume</creatorcontrib><creatorcontrib>Toublanc, Sandra</creatorcontrib><creatorcontrib>Olivier, Mickael</creatorcontrib><creatorcontrib>Simon, Antoine</creatorcontrib><creatorcontrib>Crevoisier, Renaud</creatorcontrib><creatorcontrib>Manens, Jean‐Pierre</creatorcontrib><title>Impact of MLC leaf width on volumetric‐modulated arc therapy planning for head and neck cancers</title><title>Journal of applied clinical medical physics</title><addtitle>J Appl Clin Med Phys</addtitle><description>This dosimetric study investigated the impact of multileaf collimators (MLC) leaf width in volumetric‐modulated arc therapy (VMAT) for head and neck cancers (HNC), either with a “standard” simultaneously integrated boost technique (S‐SIB) or with a “dose painting” SIB technique (DP‐SIB). HNC patients were planned either with an S‐SIB comprising three dose levels, from 56 to 70 Gy (16 patients), or with a DP‐SIB comprising five dose levels, from 56 to 84 Gy (8 patients), in 35 fractions. Two VMAT plans were calculated for each SIB technique using two Elekta MLCs: MLCi2 with 10 mm leaf width and Beam Modulator (BM) with 4 mm leaf width. Dose distributions were evaluated by comparing doses on PTVs, main OARs, and healthy tissue, and by comparing conformation indexes. Treatment efficiencies were evaluated by comparing the number of monitor units and the number of needed arcs. Comparisons of the two MLCs depending on the two SIB techniques showed: i) Regarding PTVs: Dmean and D2% on lower doses PTV decreased respectively by 0.5 Gy (p=0.01) and 0.9 Gy (p=0.01) with BM than with MLCi2 for S‐SIB; no significant difference was found for DP‐SIB; ii) Regarding OARs: for spinal cord and brainstem, D2% decreased respectively by 1.2 Gy (p=0.03) and 4.2 Gy (p=0.04) with BM than with MLCi2 for S‐SIB; for controlateral parotid, D50% decreased by 1.5 Gy (p=0.01) with BM than with MLCi2 for S‐SIB; iii) Regarding treatment efficiency : the number of monitor units was 44% (p=0.00) and 51% (p=0.01) higher with BM for S‐SIB and DP‐SIB, respectively. Two arcs were more frequently needed with BM to reach an acceptable dose distribution. This study demonstrated that Beam Modulator (4 mm leaf width) and MLCi2 (10 mm leaf width) MLCs from Elekta provided satisfactory dose distributions for treatment delivery with VMAT technique for complex HNC cases with standard and dose painting prescriptions. OAR sparing was better with BM, mainly for brainstem and spinal cord. However, delivery efficiency of VMAT plans was better with MLCi2.
PACS numbers: 87.56.N‐, 87.56.nk, 87.55.D‐</description><subject>Advantages</subject><subject>Cancer therapies</subject><subject>Dosimetry</subject><subject>Efficiency</subject><subject>Head & neck cancer</subject><subject>head and neck cancer</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Humans</subject><subject>leaf width</subject><subject>multileaf collimators</subject><subject>Neoplasm Staging</subject><subject>Optimization</subject><subject>Planning</subject><subject>Plant growth</subject><subject>Prescriptions</subject><subject>Prognosis</subject><subject>Radiation Oncology Physics</subject><subject>Radiation therapy</subject><subject>Radiometry - instrumentation</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted</subject><subject>Radiotherapy, Intensity-Modulated</subject><subject>Spinal cord</subject><subject>Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>VMAT</subject><issn>1526-9914</issn><issn>1526-9914</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkcFu1DAQhi0EomXhzglZ4sJll7HjOPEFqVpRqLQVFzhbjjPpeknsYCdb7Y1H4Bn7JLjdUhUunMbyfPOPf_-EvGawYozD-52xw7jaM-HkSkAlnpBTVnK5VIqJp4_OJ-RFSjsAxuqifk5OuOBlxaU6JeZiGI2daOjo5WZNezQdvXbttKXB033o5wGn6OzNz19DaOfeTNhSEy2dthjNeKBjb7x3_op2IdItmtz1LfVov1NrvMWYXpJnnekTvrqvC_Lt_OPX9efl5suni_XZZmklVLBkTDRSFaquGg4gG1OIuuC8tUrWAmWtmhqhQCUlNzKXrua8yDcAhreAZbEgH46649wM2Fr0UzS9HqMbTDzoYJz-u-PdVl-FvS4rJiSHLPDuXiCGHzOmSQ8uWeyzQwxz0plihSgh712Qt_-guzBHn-1pzmslFShRZQqOlI0hpYjdw2MY6Nv89F1--i4_fZtfHnnz2MTDwJ_AMiCPwLXr8fBfQX22vszfKaD4DZLoqUY</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Lafond, Caroline</creator><creator>Chajon, Enrique</creator><creator>Devillers, Anne</creator><creator>Louvel, Guillaume</creator><creator>Toublanc, Sandra</creator><creator>Olivier, Mickael</creator><creator>Simon, Antoine</creator><creator>Crevoisier, Renaud</creator><creator>Manens, Jean‐Pierre</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M2P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201311</creationdate><title>Impact of MLC leaf width on volumetric‐modulated arc therapy planning for head and neck cancers</title><author>Lafond, Caroline ; Chajon, Enrique ; Devillers, Anne ; Louvel, Guillaume ; Toublanc, Sandra ; Olivier, Mickael ; Simon, Antoine ; Crevoisier, Renaud ; Manens, Jean‐Pierre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6070-114b693987b2006ba348322dc9684e689b8e03e9662a6e96f8223e0300a2d0e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Advantages</topic><topic>Cancer therapies</topic><topic>Dosimetry</topic><topic>Efficiency</topic><topic>Head & neck cancer</topic><topic>head and neck cancer</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Humans</topic><topic>leaf width</topic><topic>multileaf collimators</topic><topic>Neoplasm Staging</topic><topic>Optimization</topic><topic>Planning</topic><topic>Plant growth</topic><topic>Prescriptions</topic><topic>Prognosis</topic><topic>Radiation Oncology Physics</topic><topic>Radiation therapy</topic><topic>Radiometry - instrumentation</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted</topic><topic>Radiotherapy, Intensity-Modulated</topic><topic>Spinal cord</topic><topic>Studies</topic><topic>Tomography, X-Ray Computed</topic><topic>VMAT</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lafond, Caroline</creatorcontrib><creatorcontrib>Chajon, Enrique</creatorcontrib><creatorcontrib>Devillers, Anne</creatorcontrib><creatorcontrib>Louvel, Guillaume</creatorcontrib><creatorcontrib>Toublanc, Sandra</creatorcontrib><creatorcontrib>Olivier, Mickael</creatorcontrib><creatorcontrib>Simon, Antoine</creatorcontrib><creatorcontrib>Crevoisier, Renaud</creatorcontrib><creatorcontrib>Manens, Jean‐Pierre</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of applied clinical medical physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lafond, Caroline</au><au>Chajon, Enrique</au><au>Devillers, Anne</au><au>Louvel, Guillaume</au><au>Toublanc, Sandra</au><au>Olivier, Mickael</au><au>Simon, Antoine</au><au>Crevoisier, Renaud</au><au>Manens, Jean‐Pierre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of MLC leaf width on volumetric‐modulated arc therapy planning for head and neck cancers</atitle><jtitle>Journal of applied clinical medical physics</jtitle><addtitle>J Appl Clin Med Phys</addtitle><date>2013-11</date><risdate>2013</risdate><volume>14</volume><issue>6</issue><spage>40</spage><epage>52</epage><pages>40-52</pages><issn>1526-9914</issn><eissn>1526-9914</eissn><abstract>This dosimetric study investigated the impact of multileaf collimators (MLC) leaf width in volumetric‐modulated arc therapy (VMAT) for head and neck cancers (HNC), either with a “standard” simultaneously integrated boost technique (S‐SIB) or with a “dose painting” SIB technique (DP‐SIB). HNC patients were planned either with an S‐SIB comprising three dose levels, from 56 to 70 Gy (16 patients), or with a DP‐SIB comprising five dose levels, from 56 to 84 Gy (8 patients), in 35 fractions. Two VMAT plans were calculated for each SIB technique using two Elekta MLCs: MLCi2 with 10 mm leaf width and Beam Modulator (BM) with 4 mm leaf width. Dose distributions were evaluated by comparing doses on PTVs, main OARs, and healthy tissue, and by comparing conformation indexes. Treatment efficiencies were evaluated by comparing the number of monitor units and the number of needed arcs. Comparisons of the two MLCs depending on the two SIB techniques showed: i) Regarding PTVs: Dmean and D2% on lower doses PTV decreased respectively by 0.5 Gy (p=0.01) and 0.9 Gy (p=0.01) with BM than with MLCi2 for S‐SIB; no significant difference was found for DP‐SIB; ii) Regarding OARs: for spinal cord and brainstem, D2% decreased respectively by 1.2 Gy (p=0.03) and 4.2 Gy (p=0.04) with BM than with MLCi2 for S‐SIB; for controlateral parotid, D50% decreased by 1.5 Gy (p=0.01) with BM than with MLCi2 for S‐SIB; iii) Regarding treatment efficiency : the number of monitor units was 44% (p=0.00) and 51% (p=0.01) higher with BM for S‐SIB and DP‐SIB, respectively. Two arcs were more frequently needed with BM to reach an acceptable dose distribution. This study demonstrated that Beam Modulator (4 mm leaf width) and MLCi2 (10 mm leaf width) MLCs from Elekta provided satisfactory dose distributions for treatment delivery with VMAT technique for complex HNC cases with standard and dose painting prescriptions. OAR sparing was better with BM, mainly for brainstem and spinal cord. However, delivery efficiency of VMAT plans was better with MLCi2.
PACS numbers: 87.56.N‐, 87.56.nk, 87.55.D‐</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>24257269</pmid><doi>10.1120/jacmp.v14i6.4074</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Advantages Cancer therapies Dosimetry Efficiency Head & neck cancer head and neck cancer Head and Neck Neoplasms - pathology Head and Neck Neoplasms - radiotherapy Humans leaf width multileaf collimators Neoplasm Staging Optimization Planning Plant growth Prescriptions Prognosis Radiation Oncology Physics Radiation therapy Radiometry - instrumentation Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted Radiotherapy, Intensity-Modulated Spinal cord Studies Tomography, X-Ray Computed VMAT |
| title | Impact of MLC leaf width on volumetric‐modulated arc therapy planning for head and neck cancers |
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