A hybrid planning strategy for stereotactic body radiation therapy of early stage non-small-cell lung cancer.

A hybrid planning strategy for stereotactic body radiation therapy of early stage non-small-cell lung cancer. J Appl Clin Med Phys. 2018 Oct 03;: Authors: Liu H, Sintay B, Pearman K, Shang Q, Hayes L, Maurer J, Vanderstraeten C, Wiant D Abstract Currently dynamic conformal arcs (DCA) and volumetric modulated arc therapy (VMAT) are two popular planning techniques to treat lung stereotactic body radiation therapy (SBRT) patients. Of the two, DCA has advantages in terms of multi-leaf collimator (MLC) motion, positioning error, and delivery efficiency. However, VMAT is often the choice when critical organ sparing becomes important. We developed a hybrid strategy to incorporate DCA component into VMAT planning, results were compared with DCA and VMAT plans. Four planning techniques were retrospectively simulated for 10 lung SBRT patients: DCA, Hybrid-DCA (2/3 of the doses from DCA beams), Hybrid-VMAT (2/3 of the doses from VMAT beams) and VMAT. Plan complexity was accessed by modulation complexity score (MCS). Conformity index (CI) for the planning target volume (PTV), V20 and V5 for the lung, V30 for the chestwall, and maximum dose to all other critical organs were calculated. Plans were compared with regard to these metrics and measured agreement between the planned and delivered doses. DCA technique did not result in acceptable plan quality due to target location for five patients. Hybrid-DCA produced one unacceptable plan, and Hybrid-...
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Tags: J Appl Clin Med Phys Source Type: research