• Title/Summary/Keyword: Arc therapy

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Comparison study of intensity modulated arc therapy using single or multiple arcs to intensity modulated radiation therapy for high-risk prostate cancer

  • Ashamalla, Hani;Tejwani, Ajay;Parameritis, Ioannis;Swamy, Uma;Luo, Pei Ching;Guirguis, Adel;Lavaf, Amir
    • Radiation Oncology Journal
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    • v.31 no.2
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    • pp.104-110
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    • 2013
  • Purpose: Intensity modulated arc therapy (IMAT) is a form of intensity modulated radiation therapy (IMRT) that delivers dose in single or multiple arcs. We compared IMRT plans versus single-arc field (1ARC) and multi-arc fields (3ARC) IMAT plans in high-risk prostate cancer. Materials and Methods: Sixteen patients were studied. Prostate ($PTV_P$), right pelvic ($PTV_{RtLN}$) and left pelvic lymph nodes ($PTV_{LtLN}$), and organs at risk were contoured. $PTV_P$, $PTV_{RtLN}$, and $PTV_{LtLN}$ received 50.40 Gy followed by a boost to $PTV_B$ of 28.80 Gy. Three plans were per patient generated: IMRT, 1ARC, and 3ARC. We recorded the dose to the PTV, the mean dose ($D_{MEAN}$) to the organs at risk, and volume covered by the 50% isodose. Efficiency was evaluated by monitor units (MU) and beam on time (BOT). Conformity index (CI), Paddick gradient index, and homogeneity index (HI) were also calculated. Results: Average Radiation Therapy Oncology Group CI was 1.17, 1.20, and 1.15 for IMRT, 1ARC, and 3ARC, respectively. The plans' HI were within 1% of each other. The $D_{MEAN}$ of bladder was within 2% of each other. The rectum $D_{MEAN}$ in IMRT plans was 10% lower dose than the arc plans (p < 0.0001). The GI of the 3ARC was superior to IMRT by 27.4% (p = 0.006). The average MU was highest in the IMRT plans (1686) versus 1ARC (575) versus 3ARC (1079). The average BOT was 6 minutes for IMRT compared to 1.3 and 2.9 for 1ARC and 3ARC IMAT (p < 0.05). Conclusion: For high-risk prostate cancer, IMAT may offer a favorable dose gradient profile, conformity, MU and BOT compared to IMRT.

Dosimetric comparison of volumetric modulated arc therapy with robotic stereotactic radiation therapy in hepatocellular carcinoma

  • Paik, Eun Kyung;Kim, Mi-Sook;Choi, Chul Won;Jang, Won Il;Lee, Sung Hyun;Choi, Sang Hyoun;Kim, Kum Bae;Lee, Dong Han
    • Radiation Oncology Journal
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    • v.33 no.3
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    • pp.233-241
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    • 2015
  • Purpose: To compare volumetric modulated arc therapy of RapidArc with robotic stereotactic body radiation therapy (SBRT) of CyberKnife in the planning and delivery of SBRT for hepatocellular carcinoma (HCC) treatment by analyzing dosimetric parameters. Materials and Methods: Two radiation treatment plans were generated for 29 HCC patients, one using Eclipse for the RapidArc plan and the other using Multiplan for the CyberKnife plan. The prescription dose was 60 Gy in 3 fractions. The dosimetric parameters of planning target volume (PTV) coverage and normal tissue sparing in the RapidArc and the CyberKnife plans were analyzed. Results: The conformity index was $1.05{\pm}0.02$ for the CyberKnife plan, and $1.13{\pm}0.10$ for the RapidArc plan. The homogeneity index was $1.23{\pm}0.01$ for the CyberKnife plan, and $1.10{\pm}0.03$ for the RapidArc plan. For the normal liver, there were significant differences between the two plans in the low-dose regions of $V_1$ and $V_3$. The normalized volumes of $V_{60}$ for the normal liver in the RapidArc plan were drastically increased when the mean dose of the PTVs in RapidArc plan is equivalent to the mean dose of the PTVs in the CyberKnife plan. Conclusion: CyberKnife plans show greater dose conformity, especially in small-sized tumors, while RapidArc plans show good dosimetric distribution of low dose sparing in the normal liver and body.

Dose Distribution Comparison between Arc Radiation Therapy and Tomotherapy (아크치료기법과 토모테라피치료의 선량분포 비교)

  • Kim, Ji-Yoon;Lee, Seung-Chul;Cheon, Geum-Seong;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.15 no.5
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    • pp.723-730
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    • 2021
  • This study tries to compare dose distribution between arc radiation therapy and Tomotherapy, which are main radiation therapy modalities. The subjects of this study are lung cancer patients. For planning target volume (PTV), a dose of 60.0 Gy was set as a basis. The PTVmean of Arc was 61.04 Gy, and that of Tomotherapy was 58.50 Gy. The total lung capacities of Arc and Tomotherapy were 3.0 Gy and 4.24 Gy, respectively. The mean heart doses of Arc and Tomotherapy were 0.13 and 0.34, respectively; the mean trachea dose of Arc and Tomotherapy were 1.35 and 2.58, respectively; the mean esophagus dose of Arc and Tomotherapy were 0.41 and 0.86, respectively; the mean spinal cord dose of Arc and Tomotherapy were 3.65 and 4.68, respectively. With regard to the appropriateness of therapeutic effect in DHV, both modalities seemed appropriate. Tomotherapy protected normal tissues better than Arc radiation therapy. In Tomotherapy, patients need to have treatment long in a limited space. If such a point is overcome, Tomotherapy is better. Otherwise, Arc radiation therapy can be applied. This study was conducted with treatment planning images. Therefore, the results of this study are different from actual treatment results. If more research is conducted to overcome the limitation, the effects of radiation therapy are expected to increase further.

Comparison of Dosimetric Parameters Based on Beam Arrangement Changes in HA-WBRT by Using VMAT Technique: A Phantom Study (VMAT 기법을 활용한 HA-WBRT에서 빔 배열 변화에 따른 선량학적 인자 비교: 팬텀 연구)

  • Sung-Kuk Park;Dong-Hyun Kim
    • Journal of radiological science and technology
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    • v.47 no.4
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    • pp.271-278
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    • 2024
  • This study aimed to evaluate the impact of changes in beam arrangement and arc counts on dosimetric factors in volumetric modulated arc therapy (VMAT) inverse radiation therapy planning for hippocampal-avoidance whole brain radiation therapy (HA-WBRT) by using the Elekta Monaco radiation therapy planning system (RTPs). For coplanar VMAT, both the arc per beam (APB) method and the beam determined arc(BDA) method, which is determined by the number of beams, were applied. For non-coplanar VMAT, the BDA method was utilized, and a total of 9 treatment plans were established by varying the arc counts. All radiation therapy plans met the radiation oncology group (RTOG) 0933 protocol standards, and 14 dosimetric factors were compared and analyzed. The results showed that the BDA-NC VMAT method demonstrated superior performance in terms of planning target volume (PTV) coverage and protection of normal organs, while APB-VMAT was advantageous in terms of hippocampal protection, monitor unit and delivery time. This study is expected to contribute to the efficient establishment of HA-WBRT plans considering the changes in beam arrangement and rotation arc numbers in Monaco RTPs.

A Case Study of Chronic Plantar Pompholyx Including Steroids Side Effects (스테로이드제제 부작용을 동반한 만성 족부 한포진 치험 1례)

  • Kang, Da-Hae;Kim, Jung-Hyun;Lim, Hae-Won;Kim, Jee-Young;Kwon, Kang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.1
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    • pp.181-191
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    • 2011
  • Backgrounds : Pompholyx is a distinctive reaction pattern presenting as symmetric vesicular hand and foot dermatitis. Other than acute symptoms like itching and vesicles, chronic changes with scaling, fissure and pain may follow. As patients are treated by steroid for a long period, it tends to present side effects after quitting steroid treatment. Objectives : This study was carried out to investigate the effect of carbon arc lamp therapy and oriental medical therapy that venesection therapy, ointments and herbal medicine on chronic plantar pompholyx including steroids side effects. Methods : We treated one case of chronic plantar pompholyx which had continued about 10 years, including steroids side effects with venesection therapy, carbon arc lamp therapy, ointments and herbal medicine. To evaluate the results of this treatment, we categorized symptoms into six items which are vesicles, itching, fissures, pain, erosions and scales. Results : Except mild itching, vesicles and scales in a small area, all the symptoms were subsided. Conclusions : It is considered that various kinds of oriental medical therapy including carbon arc lamp therapy could replace steroid therapy which has many side effects.

Deep inspiration breath-hold (DIBH) 적용한 림프절이 포함된 왼편 유방암의 방사선 치료계획에 따른 주변 장기 선량 평가

  • Jeong, Da-Lee;Gang, Hyo-Seok;Choe, Byeong-Jun;Park, Sang-Jun;Lee, Geon-Ho;Lee, Du-Sang;An, Min-U;Jeon, Myeong-Su
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.27-35
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    • 2017
  • Purpose: On the left side, breast cancer patients have more side effects than those on the right side because of unnecessary doses in normal organs such as heart and lung. DIBH is performed to reduce this. To evaluate the dose of peripheral organs in the left breast cancer including supraclavicular lymph nodes and internal mammary lymph nodes according to the treatment planning method of Conventional Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy. Materials and Methods: We performed CT-simulation using free breathing and deep inspiration breath-hold technique for 8 patients including left supraclavicular lymph nodes and internal mammary lymph nodes. Based on the acquired CT images, the contour of the body is drawn and the convention is performed so that $95%{\leftarrow}PTV$, $Dmax{\leftarrow}110%$. Conventional Radiation Therapy used a one portal technique on the supraclavicular lymph node and used a field in field technique tangential beam on the breast. Intensity Modulated Radiation Therapy was composed of 7 static fields. Volumetric Modulated Arc Therapy was planned using 2 ARC with a turning radius of $290^{\circ}$ to $179^{\circ}$. The peripheral normal organs dose was analyzed by referring to the dose volume of Eclipse. Results: By applying the deep inspiration breath-hold technique, the mean interval between the heart and chest wall increased $1.6{\pm}0.6cm$. The mean dose of lung was $19.2{\pm}1.0Gy$, which was the smallest value in Intensity Modulated Radiation Therapy. The V30 (%) of the heart was $2.0{\pm}1.9$, which was the smallest value in Intensity Modulated Radiation Therapy. In the left anterior descending coronary artery, the dose was $25.4{\pm}5.4Gy$, which was the smallest in Intensity Modulated Radiation Therapy. The maximum dose value of the Right breast was $29.7{\pm}4.3Gy$ at Intensity Modulated Radiation Therapy. Conclusion: When comparing the values of surrounding normal organs, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy were applicable values for treatment. Among them, Intensity Modulated Radiation Therapy is considered to be a suitable treatment planning method.

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An Effect of Carbon Arc Lamp and Low Level Laser Therapy on the Changes of Burned Mice's Cytokine (탄소방전등과 저강도 레이저 조사가 화상 쥐의 Cytokine 변화에 미치는 영향)

  • Park, Don-Mog;Park, Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.18 no.6
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    • pp.13-21
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    • 2006
  • Purpose: To provide the basic method for physical therapy to contribute to early stage treatment of a burned patients. We investigated whether or not carbon arc lamp treatment and low level laser one among various laser treatments have the effect of reducing Cytokine, and to elucidate the effect of carbon arc lamp treatment and laser one. Methods: The 6-week old BALB/c types of 92 mice were used for the experimental test, and they were burned with $100^{\circ}C$ water, they were divided into 4 groups in accordance with the method of treatment respectively. And the blood and the tissue from the subject of each group were extracted and analyzed each time after they were cured for 3, 6, 9 days. For the analysis of the results, SPSS statistical program was used in this study. Results: The quantity of $TNF-{\alpha}$ and $IL-1{\beta}$ within the blood of a burned mouse increased more than that of a normal mouse(p<0.01). In only a burned mouse, carbon arc lamp treatment gave the effect on the decrease of $TNF-{\alpha}$ thickness the 6th day to the 9th day(p<0.01). $IL-1{\beta}$ quantity was more decreased than that of control group around the 6th day. In comparison with only a control group, low level laser treatment has more significant effect in decreasing the quantity of $TNF-{\alpha}$ a and $IL-1{\beta}$ than the two different methods(p<0.01). In case that the two treatment methods, carbon arc lamp treatment and low level laser, were executed together, there was the effect of decreasing $TNF-{\alpha}$ until the 6th day(p<0.01). Conclusion: Both low level laser treatment and carbon arc lamp one would be able to have an effect on the inflammation inhibition of burned patients and tissues reproduction. However, it must be also considered for the two treatments to be done at the same time.

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Analysis of Dose Delivery Error in Conformal Arc Therapy Depending on Target Positions and Arc Trajectories (동적조형회전조사 시 표적종양의 위치변위와 조사반경의 변화에 따른 선량전달 오류분석)

  • Kang, Min-Young;Lee, Bo-Ram;Kim, You-Hyun;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.34 no.1
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    • pp.51-58
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    • 2011
  • The aim of the study is to analyze the dose delivery error depending on the depth variation according to target positions and arc trajectories by comparing the simulated treatment planning with the actual dose delivery in conformal arc therapy. We simulated the conformal arc treatment planning with the three target positions (center, 2.5 cm, and 5 cm in the phantom). For the experiments, IMRT body phantom (I’mRT Phantom, Wellhofer Dosimetry, Germany) was used for treatment planning with CT (Computed Tomography, Light speed 16, GE, USA). The simulated treatment plans were established by three different target positions using treatment planning system (Eclipse, ver. 6.5, VMS, Palo Alto, USA). The radiochromic film (Gafchromic EBT2, ISP, Wayne, USA) and dose analysis software (OmniPro-IMRT, ver. 1.4, Wellhofer Dosimetry, Germany) were used for the measurement of the planned arc delivery using 6 MV photon beam from linear accelerator (CL21EX, VMS, Palo Alto, USA). Gamma index (DD: 3%, DTA: 2 mm) histogram and dose profile were evaluated for a quantitative analysis. The dose distributions surrounded by targets were also compared with each plans and measurements by conformity index (CI), and homogeneity index (HI). The area covered by 100% isodose line was compared to the whole target area. The results for the 5 cm-shifted target plan show that 23.8%, 35.6%, and 37% for multiple conformal arc therapy (MCAT), single conformal arc therapy (SCAT), and multiple static beam therapy, respectively. In the 2.5 cm-shifted target plan, it was shown that 61%, 21.5%, and 14.2%, while in case of center-located target, 70.5%, 14.1%, and 36.3% for MCAT, SCAT, and multiple static beam therapy, respectively. The values were resulted by most superior in the MCAT, except the case of the 5 cm-shifted target. In the analysis of gamma index histogram, it was resulted of 37.1, 27.3, 29.2 in the SCAT, while 9.2, 8.4, 10.3 in the MCAT, for the target positions of center, shifted 2.5 cm and 5 cm, respectively. The fail proportions of the SCAT were 2.8 to 4 times as compared to those of the MCAT. In conclusion, dose delivery error could be occurred depending on the target positions and arc trajectories. Hence, if the target were located in the biased position, the accurate dose delivery could be performed through the optimization of depth according to arc trajectory.

Minimization of Treatment Time Using Partial-Arc Volumetric Modulated Arc Therapy with Bladder Filling Protocol for Prostate Cancer

  • Hojeong Lee;Dong Woon Kim;Ji Hyeon Joo;Yongkan Ki;Wontaek Kim;Dahl Park;Jiho Nam;Dong Hyeon Kim;Hosang Jeon
    • Progress in Medical Physics
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    • v.33 no.4
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    • pp.101-107
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    • 2022
  • Purpose: Radiotherapy after bladder filling protocol (BFP) is known to enhance treatment quality and reduce side effects in prostate cancer, a common male solid cancer globally. However, due to the need to hold back urine during treatment, patients frequently complain of discomfort, and treatment is frequently suspended when patients urinate during treatment and urine penetrates the treatment device, causing malfunction. Therefore, the effect of minimizing treatment time when partial-arc volumetric modulated arc therapy (VMAT) was used instead of full-arc was assessed in this study. Methods: A total of 70 plans were created in 10 patients using 7 different arc sizes, and the treatment time for each plan was calculated. Results: Reduced arc size by half resulted in a 54.4% decrease in mean treatment duration, with a proportional tendency observed. Furthermore, the effect of VMAT arc size reduction on target dose homogeneity was significantly limited, and the effect on surrounding organs at risk (OAR) was negligible. It should be noted, however, that when the arc size decreases by >40%, the dose increases in the area without OAR around the target. Conclusions: The results of this study demonstrated that partial-arc VMAT for enhancing treatment convenience and efficacy of prostate cancer patients undergoing BFP can achieve a considerable reduction in treatment time while preserving treatment quality, and it is expected to be useful for partial-arc VMAT plan design and implementation in practice.

A Study on ARC Therapy of 18MeV Linear Accelerator (18MeV 선형가속기의 ARC Therapy에 관한 고찰)

  • Kim, Sung-Kyu;Shin, Sei-One;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.31-36
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    • 1988
  • In recent years there has been a growing interest in all forms of rotational therapy, and many different types of therapy machines designed for this kind of treatment have become available. To the medical radiation physicist, the dosimetry of rotation therapy has presented a number of interesting problems, and much useful work has been published on the basic data of dose distribution and dosage calculation. The setting dose for ARC therapy were obtained by computer calculation and measurement with cylindrical phantom. Authors compared computer calculation with measured value. And in ARC therapy, the region of maximum dose is shifted from the tumor center. The extent of shift was analyzed by isodose distribution for ARC therapy techniques.

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