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Fogliata A, Scorsetti M, Navarria P, Catalano M, Clivio A, Cozzi L, Lobefalo F, Nicolini G, Palumbo V, Pellegrini C, Reggiori G, Roggio A, Vanetti E, Alongi F, Pentimalli S, Mancosu P. Dosimetric comparison between VMAT with different dose calculation algorithms and protons for soft-tissue sarcoma radiotherapy. Acta Oncol 2013; 52:545-52. [PMID: 22671576 DOI: 10.3109/0284186x.2012.689853] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To appraise the potential of volumetric modulated arc therapy (VMAT, RapidArc) and proton beams to simultaneously achieve target coverage and enhanced sparing of bone tissue in the treatment of soft-tissue sarcoma with adequate target coverage. MATERIAL AND METHODS Ten patients presenting with soft-tissue sarcoma of the leg were collected for the study. Dose was prescribed to 66.5 Gy in 25 fractions to the planning target volume (PTV) while significant maximum dose to the bone was constrained to 50 Gy. Plans were optimised according to the RapidArc technique with 6 MV photon beams or for intensity modulated protons. RapidArc photon plans were computed with: 1) AAA; 2) Acuros XB as dose to medium; and 3) Acuros XB as dose to water. RESULTS All plans acceptably met the criteria of target coverage (V95% >90-95%) and bone sparing (D(1 cm3) <50 Gy). Significantly higher PTV dose homogeneity was found for proton plans. Near-to-maximum dose to bone was similar for RapidArc and protons, while volume receiving medium/low dose levels was minimised with protons. Similar results were obtained for the remaining normal tissue. Dose distributions calculated with the dose to water option resulted ~5% higher than corresponding ones computed as dose to medium. CONCLUSION High plan quality was demonstrated for both VMAT and proton techniques when applied to soft-tissue sarcoma.
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Affiliation(s)
- Antonella Fogliata
- Oncology Institute of Southern Switzerland, Medical Physics Unit,
Bellinzona, Switzerland
| | - Marta Scorsetti
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Piera Navarria
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Maddalena Catalano
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Alessandro Clivio
- Oncology Institute of Southern Switzerland, Medical Physics Unit,
Bellinzona, Switzerland
| | - Luca Cozzi
- Oncology Institute of Southern Switzerland, Medical Physics Unit,
Bellinzona, Switzerland
| | - Francesca Lobefalo
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Giorgia Nicolini
- Oncology Institute of Southern Switzerland, Medical Physics Unit,
Bellinzona, Switzerland
| | - Valentina Palumbo
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Chiara Pellegrini
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Giacomo Reggiori
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Antonella Roggio
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Eugenio Vanetti
- Oncology Institute of Southern Switzerland, Medical Physics Unit,
Bellinzona, Switzerland
| | - Filippo Alongi
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Sara Pentimalli
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
| | - Pietro Mancosu
- IRCCS Istituto Clinico Humanitas, Radiation Oncology,
Rozzano, Milan, Italy
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