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Ito T, Monzen H, Kubo K, Kosaka H, Yanagi Y, Sakai Y, Inada M, Doi H, Nishimura Y. Dose difference between anisotropic analytical algorithm (AAA) and Acuros XB (AXB) caused by target's air content for volumetric modulated arc therapy of head and neck cancer. Rep Pract Oncol Radiother 2023; 28:399-406. [PMID: 37795404 PMCID: PMC10547402 DOI: 10.5603/rpor.a2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/23/2022] [Indexed: 10/06/2023] Open
Abstract
Background We clarified the dose difference between the anisotropic analytical algorithm (AAA) and Acuros XB (AXB) with increasing target's air content using a virtual phantom and clinical cases. Materials and methods Whole neck volumetric modulated arc therapy (VMAT) plan was transferred into a virtual phantom with a cylindrical air structure at the center. The diameter of the air structure was changed from 0 to 6 cm, and the target's air content defined as the air/planning target volume (PTV) in percent (air/PTV) was varied. VMAT plans were recalculated by AAA and AXB with the same monitor unit (MU) and multi-leaf collimator (MLC) motions. The dose at each air/PTV (5%-30%) was compared between each algorithm with D98%, D95%, D50% and D2% for the PTV. In addition, MUs were also compared with the same MLC motions between the D95% prescription with AAA (AAA_D95%), AXB_D95%, and the prescription to 100% minus air/PTV (AXB_D100%-air/PTV) in clinical cases of head and neck (HNC). Results When air/PTV increased (5-30%), the dose differences between AAA and AXB for D98%, D95%, D50% and D2% were 3.08-15.72%, 2.35-13.92%, 0.63-4.59%, and 0.14-6.44%, respectively. At clinical cases with air/PTV of 5.61% and 28.19%, compared to AAA_D95%, the MUs differences were, respectively, 2.03% and 6.74% for AXB_D95% and 1.80% and 0.50% for AXB_D100%-air/PTV. Conclusion The dose difference between AAA and AXB increased as the target's air content increased, and AXB_D95% resulted in a dose escalation over AAA_D95% when the target's air content was ≥ 5%. The D100%-air/PTV of PTV using AXB was comparable to the D95% of PTV using AAA.
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Affiliation(s)
- Takaaki Ito
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
- Department of Radiological Technology, Kobe City Nishi-Kobe Medical Center, Kobe, Hyogo, Japan
| | - Hajime Monzen
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Kazuki Kubo
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Hiroyuki Kosaka
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Yuya Yanagi
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Yusuke Sakai
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Masahiro Inada
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
| | - Hiroshi Doi
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
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Accuracy Evaluation of Collapsed Cone Convolution Superposition Algorithms for the Nasopharynx Interface in the Early Stage of Nasopharyngeal Carcinoma. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5227609. [PMID: 35669729 PMCID: PMC9167114 DOI: 10.1155/2022/5227609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/10/2022] [Indexed: 11/18/2022]
Abstract
This study combined the use of radiation dosimeteric measurements and a custom-made anthropomorphic phantom in order to evaluate the accuracy of therapeutic dose calculations at the nasopharyngeal air-tissue interface. The doses at the nasopharyngeal air-tissue interface obtained utilizing the Pinnacle and TomoTherapy TPS, which are based on collapsed cone convolution superposition (CCCS) algorithms, were evaluated and measured under single
,
, two parallel opposed
and clinical fields for early stage of nasopharyngeal carcinoma by using EBT3, GR-200F, and TLD 100. At the air-tissue interface under a
field, the TPS dose calculation values were in good agreement with the dosimeter measurement with all differences within 3.5%. When measured the single field
, the differences between the average dose were measured at the distal interface for EBT3, GR-200F, and TLD-100 and the calculation values were -15.8%, -16.4%, and -4.9%, respectively. When using the clinical techniques such as IMRT, VMAT, and tomotherapy, the measurement results at the interface for all three techniques did not imply under dose. Small-field sizes will lead to dose overestimation at the nasopharyngeal air-tissue interface due to electronic disequilibrium when using CCCS algorithms. However, under clinical applications of multiangle irradiation, the dose errors caused by this effect were not significant.
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Gan W, Duan Y, Wang H, Shao Y, Chen H, Feng A, Gu H, Huang Y, Ying Y, Fu X, Quan H, Xu Z. Dosimetric effect of intensity-modulated radiation therapy for postoperative non-small cell lung cancer with and without air cavity in the planning target volume. Med Dosim 2021; 47:32-37. [PMID: 34551878 DOI: 10.1016/j.meddos.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/02/2021] [Accepted: 07/24/2021] [Indexed: 12/24/2022]
Abstract
To evaluate the dosimetric effect of intensity-modulated radiation therapy (IMRT) for postoperative non-small cell lung cancer (NSCLC), with and without the air cavity in the planning target volume (PTV). Two kinds of IMRT plans were made for 21 postoperative NSCLC patients. In Plan-0: PTV included the tracheal air cavity, and in Plan-1: the air cavity was subtracted from the PTV. For PTV, the dosimetric parameters, including Dmean, D98, D95, D2, D0.2, conformity index (CI), and homogeneity index (HI) were evaluated. For organs at risk (OARs), the evaluation indexes, included the V5, V20 and the mean lung dose (MLD) of total lung, the V30, V40, and the mean heart dose (MHD) of heart, the spinal cord Dmax, and the V35 and the mean esophageal dose (MED) of esophagus. The number of segments and MUs were also recorded. Additionally, the correlation between the Plan-1 dosimetric change value relative to Plan-0, the size of air cavity, and the volume proportion of the cavity in the PTV was also analyzed. The Dmean of PTV, D2, D0.2, HI and CI in Plan-1 decreased compared with those in Plan-0. For OARs, the V30, MHD, and MED also decreased. The CI change value of Plan-1 relative to Plan-0 had a significantly negative correlation with the size and the volume proportion of air cavity, and the MED change value also had a significantly negative correlation with the air cavity size. The IMRT plans for patients with postoperative NSCLC can achieve a better target dose distribution and offer an improved sparing of the heart and esophagus by removing the PTV air cavity, while reducing the target conformity. The change value of CI and MED had a significantly negative correlation with the air cavity size.
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Affiliation(s)
- Wutian Gan
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China; Shcool of Physics and Technology, University of Wuhan, Wuhan, China
| | - Yanhua Duan
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Wang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Shao
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Chen
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Aihui Feng
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hengle Gu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Huang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanchen Ying
- Department of Radiation Physics, Zhejiang Cancer Hospital, University of Chinese Academy of Sciences, Zhejiang, China
| | - Xiaolong Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Quan
- Shcool of Physics and Technology, University of Wuhan, Wuhan, China
| | - Zhiyong Xu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
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4
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Zeng R, Wang H, Cai X, Guo X, Ping Y, Yang Q. Radiotherapy for Primary Tracheal Carcinoma: Experience at a Single Institution. Technol Cancer Res Treat 2021; 20:15330338211034273. [PMID: 34372715 PMCID: PMC8361538 DOI: 10.1177/15330338211034273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: There is limited understanding of tracheal carcinoma (TC) because of its rarity. We examined the efficacy of radiotherapy (RT) for patients with primary TC. Methods: We analyzed the records of 32 patients with primary TC who received RT at our center between November 1996 and December 2016. Results: Thirteen patients received adjuvant RT and 18 received definitive RT. Eight patients achieved complete remission (CR) after definitive RT. Among all patients, the 5-year overall survival (OS) rate was 46.9% and the locoregional progression free survival (LRPFS) rate was 68.1%. Univariate analysis indicated the 5-year OS was better in those with adenoid cystic adenocarcinoma than squamous cell carcinoma (P = 0.001); the 5-year LRPFS was better in patients who received surgical resection than those who did not (92.9% vs 46.4%, P = 0.013) and in patients who received postoperative RT than in those who received definitive RT (91.7% vs 50.1%, P = 0.038). A sub-group univariate analysis indicated the 5-year PFS was better for those who received at least 68 Gy of radiation (44.4% vs 13.0%, P = 0.044). Patients who achieved CR had a better 5-year PFS than those who did not (57.1% vs 10%, P = 0.006). No patients had a toxicity of grade 3 or more. Conclusions: Adjuvant and definitive RT are safe and effective treatments for TC. Patients who received dosages of 68 Gy or more and who had complete tumor regression following definitive RT seemed to have better long-term survival.
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Affiliation(s)
- Ruifang Zeng
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China.,Ruifang Zeng and Hanyu Wang contribute equally to this work
| | - Hanyu Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China.,Ruifang Zeng and Hanyu Wang contribute equally to this work
| | - Xiaohui Cai
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoqiong Guo
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanan Ping
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiuyuan Yang
- Department of Radiation Oncology, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
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5
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Scott J, Dundas K, Surjan Y, King O, Arumugam S, Deshpande S, Udovitch M, Lee M. Quantifying and Assessing the Dosimetric Impact of Changing Gas Volumes Throughout the Course of VMAT Radiation Therapy of Upper Gastrointestinal Tumors. Adv Radiat Oncol 2021; 6:100650. [PMID: 34195488 PMCID: PMC8233468 DOI: 10.1016/j.adro.2021.100650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/07/2020] [Accepted: 01/05/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose This retrospective patient study assessed the consistency of abdominal gas presence throughout radiation therapy for patients with upper gastrointestinal cancer and determined the impact of variations in gas volume on the calculated dose distribution of volumetric modulated arc therapy. Methods and Materials Eight patients with pancreatic cancer were included for analysis. A plan library consisting of 3 reference plans per patient (Ref0.0, Ref0.5, and Ref1.0) was created based on planning computed tomography (CT) with density overrides of 0.0, 0.5, and 1.0 applied to gas volumes, respectively. Corresponding cone beam CT (CBCT) data sets were obtained and density overrides were applied to enable fractional dose calculation. Variation in gas volume relative to initial volume determined from CT was assessed. Dose metrics for targets and organs at risk were compared between the accumulated CBCT dose and the planned dose of the 3 reference plans for each patient. Results There was a significant decrease in gas present from CT to treatment CBCT, with a mean decrease in volume of 48.6% for the entire cohort. Dosimetrically, all accumulated target and organ-at-risk parameters, aside from the kidneys, exhibited the smallest mean deviation from the Ref0.0 plan and largest mean deviation from the Ref1.0 plan. A statistically significant difference in mean accumulated dose to Ref0.0 and Ref1.0 was observed for the dose delivered to 95% of the planning target volume. Conclusions Significant variation in gas volumes from CT to treatment can occur throughout volumetric modulated arc therapy for pancreatic cancer. Through the use of a plan library, it was determined that initial assessment of a patient's treatment plan with an assigned gas density of 0.0 provided the most accurate prediction of the accumulated dose.
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Affiliation(s)
- Joshua Scott
- University of Newcastle, Newcastle, New South Wales, Australia.,Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia
| | - Kylie Dundas
- Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - Yolanda Surjan
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Odette King
- Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia
| | - Sankar Arumugam
- Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - Shrikant Deshpande
- Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia.,Ingham Institute, Liverpool, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
| | - Mark Udovitch
- Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia
| | - Mark Lee
- Liverpool-Macarthur Cancer Therapy Centre, Liverpool and Campbelltown, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia
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6
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Poirier Y, Becker S, Decesaris C, Culberson W, Draeger E, Gerry AJ, Johnstone CD, Gibbs A, Vujaskovic Z, Jackson IL. The Impact of Radiation Energy on Dose Homogeneity and Organ Dose in the Göttingen Minipig Total-Body Irradiation Model. Radiat Res 2020; 194:544-556. [PMID: 33045066 DOI: 10.1667/rade-20-00135.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/10/2020] [Indexed: 11/03/2022]
Abstract
Animal models of total-body irradiation (TBI) are used to elucidate normal tissue damage and evaluate the efficacy of medical countermeasures (MCM). The accuracy of these TBI models depends on the reproducibility of the radiation dose-response relationship for lethality, which in turn is highly dependent on robust radiation physics and dosimetry. However, the precise levels of radiation each organ absorbs can change dramatically when different photon beam qualities are used, due to the interplay between their penetration and the natural variation of animal sizes and geometries. In this study, we evaluate the effect of varying the radiation energy, namely cobalt-60 (Co-60); of similar penetration to a 4-MV polyenergetic beam), 6 MV and 15 MV, in the absorbed dose delivered by TBI to individual organs of eight Göttingen minipigs of varying weights (10.3-24.1 kg) and dimensions (17.5-25 cm width). The main organs, i.e. heart, lungs, esophagus, stomach, bowels, liver, kidneys and bladder, were contoured by an experienced radiation oncologist, and the volumetric radiation dose distribution was calculated using a commercial treatment planning system commissioned and validated for Co-60, 6-MV and 15-MV teletherapy units. The dose is normalized to the intended prescription at midline in the abdomen. For each animal and each energy, the body and organ dose volume histograms (DVHs) were computed. The results show that more penetrating photon energies produce dose distributions that are systematically and consistently more homogeneous and more uniform, both within individual organs and between different organs, across all animals. Thoracic organs (lungs, heart) received higher dose than prescribed while pelvic organs (bowel, bladder) received less dose than prescribed, due to smaller and wider separations, respectively. While these trends were slightly more pronounced in the smallest animals (10.3 kg, 19 cm abdominal width) and largest animals (>20 kg, ∼25 cm abdominal width), they were observed in all animals, including those in the 9-15 kg range typically used in MCM models. Some organs received an average absorbed dose representing <80% of prescribed dose when Co-60 was used, whereas all organs received average doses of >87% and >93% when 6 and 15 MV were used, respectively. Similarly, average dose to the thoracic organs reached as high as 125% of the intended dose with Co-60, compared to 115% for 15 MV. These results indicate that Co-60 consistently produces less uniform dose distributions in the Göttingen minipig compared to 6 and 15 MV. Moreover, heterogeneity of dose distributions for Co-60 is accentuated by anatomical and geometrical variations across various animals, leading to different absorbed dose delivered to organs for different animals. This difference in absorbed radiation organ doses, likely caused by the lower penetration of Co-60 and 6 MV compared to 15 MV, could potentially lead to different biological outcomes. While the link between the dose distribution and variation of biological outcome in the Göttingen minipig has never been explicitly studied, more pronounced dose heterogeneity within and between organs treated with Co-60 teletherapy units represents an additional confounding factor which can be easily mitigated by using a more penetrating energy.
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Affiliation(s)
- Yannick Poirier
- Division of Medical Physics, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland.,Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Stewart Becker
- Division of Medical Physics, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Cristina Decesaris
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Wesley Culberson
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison Wisconsin
| | - Emily Draeger
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland.,Department of Therapeutic Radiology, Yale University, New Haven, Connecticut
| | - Andrew J Gerry
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Christopher D Johnstone
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland.,Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Allison Gibbs
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Zeljko Vujaskovic
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Isabel L Jackson
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
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7
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Rani AR, Ayyangar K, Reddy AR, Kumar AA, Reddy PRY. Efficacy of MLC based cobalt-60 plans: A DVH comparison and analysis with 6 MV plans. Med Dosim 2020; 46:80-85. [PMID: 32988718 DOI: 10.1016/j.meddos.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/10/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to compare 3D treatment plans implemented using 6 MV Linac with a retrofitted multileaf collimator (MLC) based cobalt-60 plans. In this retrospective study, DVH analysis was used to compare homogeneity of dose within the target and the dose received by critical organs. A prototype MLC designed and developed as a retrofit to current cobalt-60 teletherapy machines with a dedicated 3D treatment planning system was used. Cases representing 5 tumor sites like head & neck, glottis, lung, gall bladder, stomach were taken for the study, which were planned using Eclipse treatment planning system and treated with 6 MV photon beams. The plans were re-planned using the retrofit cobalt-60 MLC with same beam arrangement and dose prescription in Radiation Oncology planning system (ROPS). For each case, DVH data was evaluated for both types of beam energies. Conformity index (CI) and homogeneity index (HI) for target were calculated and compared. The conformal plans created using cobalt MLC for five sites were found to be similar to those planned using 6 MV photon beams. CI values close to unity reflected dose uniformity in the target volume while HI evaluated the hotspots in the target volume. It was concluded that plans created using retrofit prototype MLC developed for cobalt-60 teletherapy machines can provide dose distributions comparable to 6 MV photon beams. The prototype MLC developed can provide a promising treatment option for existing telecobalt machines in implementing conformal therapy in developing countries.
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Affiliation(s)
- Akula Roopa Rani
- Department of Physics, Osmania University, Hyderabad, India; Department of Radiation Oncology, MNJ Institute of Oncology & Regional Cancer Center, Hyderabad, India; Department of Radiation Oncology, International Cancer Centre, MGMMT, Bhimavaram, India.
| | - Komanduri Ayyangar
- Department of Radiation Oncology, International Cancer Centre, MGMMT, Bhimavaram, India
| | - A R Reddy
- Department of Radiation Oncology, International Cancer Centre, MGMMT, Bhimavaram, India
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8
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Ananthi B, Dhanabalan R, Priya I, Selvaluxmy G, Vivekanandan N. Breast telecobalt beam therapy using multi-isocentric technique. Rep Pract Oncol Radiother 2020; 25:79-84. [PMID: 31908600 PMCID: PMC6938814 DOI: 10.1016/j.rpor.2019.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/15/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022] Open
Abstract
AIM To treat breast cancer patients in telecobalt unit with image based conformal radiotherapy planning using the multi-isocentric technique. BACKGROUND Breast cancer is the leading cancer among all the female cancers. With improved screening techniques, many patients are being diagnosed at an early stage and the need for radiotherapy in such patients has increased. The telecobalt machine is still a preferred machine in many of the low income countries as it is cost-effective and can offer uninterrupted treatment to large number of patients. MATERIALS AND METHODS Three hundred patients requiring radiotherapy had a computed tomography based planning. Patients were immobilized using a breast board with a thermoplastic mould. Three dimensional planning was done with the multi-isocentric technique. These patients were then simulated using a Nucletron Simulix digital simulator for field verification and were treated in a Theratron Phoenix telecobalt treatment unit. RESULTS The doses to the heart, ipsilateral lung and the conformity index were within the recommended values. The homogeneity index was not comparable; however, a section by section qualitative analysis was done and a final plan approved. As per the RTOG toxicity grading system, acute skin reaction grade 3 was observed in 3.6% of treatments to intact breast including nodal regions and in 3.5% of post mastectomy radiation patients. CONCLUSION Single isocenter technique was not feasible as the telecobalt unit did not have multileaf collimators and asymmetric jaws. With improved image based planning, a multi-isocentric technique was planned. By evaluating the dose distribution, beam modifications can be made and treatments can be given with acceptable toxicity.
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Affiliation(s)
| | | | - Iyer Priya
- Department of Radiation Oncology, Cancer Institute (WIA), Chennai, India
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9
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Seif F, Bayatiani MR, Hamidi S, Kargaran M. Investigating the Effect of Air Cavities of Sinuses on the Radiotherapy Dose Distribution Using Monte Carlo Method. J Biomed Phys Eng 2019; 9:121-126. [PMID: 30881941 PMCID: PMC6409366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/09/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Considering that some vital organs exist in the head and neck region, the treatment of tumors in this area is a crucial task. The existence of air cavities, namely sinuses, disrupt the radiotherapy dose distribution. The study aims to analyze the effect of maxillary, frontal, ethmoid and sphenoid sinuses on radiotherapy dose distribution by Monte Carlo method. MATERIAL AND METHODS In order to analyze the effect of the cavities on dose distribution, the maxillary, frontal, ethmoid and sphenoid sinus cavities were simulated with (3×3.2×2) cm3, (2×2×3.2) cm3, (1×1×1.2) cm3 and (1×1×2) cm3 dimensions. RESULTS In the analysis of the dose distribution caused by cavities, some parameters were observed, including: inhomogeneity of dose distribution in the cavities, inhomogeneity of dose on the edges of the air cavities and dispersion of the radiations after the air cavity. The amount of the dose in various situations showed differences: before the cavity a 0.64% and a 2.76% decrease, a 12.06% and a 17.17% decrease in the air zone, and a 2.25% and a 5.9% increase after the cavity. CONCLUSION The results indicate that a drop in dose before the air cavities and in the air zone occurs due to the lack of scattered radiation. Furthermore, the rise in dose was due to the passage of more radiation from the air cavity and dose deposition after the air cavity. The changes in dose distribution are dependent on the cavity size and depth. As a result, this has to be noted in the treatment planning and MU calculations of the patient.
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Affiliation(s)
- F Seif
- Ph.D of Medical Physics. Assistant professor, Department of Medical Physics and Radiotherapy, Arak university of Medical Sciences and Khansari hospital, Arak, Iran
| | - M R Bayatiani
- Ph.D of Medical Physics. Assistant professor, Department of Medical Physics and Radiotherapy, Arak university of Medical Sciences and Khansari hospital, Arak, Iran
| | - S Hamidi
- Ph.D of Physics. Associate professor, Department of Physics, Arak University, Arak, Iran
| | - M Kargaran
- Ms.c of Physics, Department of Physics, Arak University, Arak, Iran
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10
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Raj Verma T, Kumar Painuly N, Prasad Mishra S, Yoganathan S, Singh N, Bhatt M, Jamal N. Evaluation of Lung Density and Its Dosimetric Impact on Lung Cancer Radiotherapy: A Simulation Study. J Biomed Phys Eng 2019; 9:17-28. [PMID: 30881931 PMCID: PMC6409377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 09/28/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The dosimetric parameters required in lung cancer radiation therapy are taken from a homogeneous water phantom; however, during treatment, the expected results are being affected because of its inhomogeneity. Therefore, it becomes necessary to quantify these deviations. OBJECTIVE The present study has been undertaken to find out inter- and intra- lung density variations and its dosimetric impact on lung cancer radiotherapy using Monte Carlo code FLUKA and PBC algorithms. MATERIAL AND METHODS Density of 100 lungs was recorded from their CT images along with age. Then, after PDD calculated by FLUKA MC Code and PBC algorithm for virtual phantom having density 0.2 gm/cm3 and 0.4 gm/cm3 (density range obtained from CT images of 100 lungs) using Co-60 10 x10 cm2 beams were compared. RESULTS Average left and right lung densities were 0.275±0.387 and 0.270±0.383 respectively. The deviation in PBC calculated PDD were (+)216%, (+91%), (+)45%, (+)26.88%, (+)14%, (-)1%, (+)2%, (-)0.4%, (-)1%, (+)1%, (+)4%, (+)4.5% for 0.4 gm/cm3 and (+)311%, (+)177%, (+)118%, (+)90.95%, (+)72.23%, (+)55.83% ,(+)38.85%, (+)28.80%, (+)21.79%, (+)15.95%, (+)1.67%, (-) 2.13%, (+)1.27%, (+)0.35%, (-)1.79%, (-)2.75% for 0.2 gm/cm3 density mediums at depths of 1mm, 2mm, 3mm, 4mm, 5mm, 6 mm, 7 mm, 8mm, 9mm,10mm, 15mm, 30mm, 40mm, 50mm, 80mm and 100 mm, respectively. CONCLUSION Large variations in inter- and intra- lung density were recorded. PBC overestimated the dose at air/lung interface as well as inside lung. The results of Monte Carlo simulation can be used to assess the performance of other treatment planning systems used in lung cancer radiotherapy.
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Affiliation(s)
- T. Raj Verma
- King George Medical University, UP, Lucknow, India
| | | | - S. Prasad Mishra
- Dr.Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
| | - S.A. Yoganathan
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - N. Singh
- King George Medical University, UP, Lucknow, India
| | - M.L.B. Bhatt
- King George Medical University, UP, Lucknow, India
| | - N. Jamal
- King George Medical University, UP, Lucknow, India
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Lee AW, Ng WT, Pan JJ, Poh SS, Ahn YC, AlHussain H, Corry J, Grau C, Grégoire V, Harrington KJ, Hu CS, Kwong DL, Langendijk JA, Le QT, Lee NY, Lin JC, Lu TX, Mendenhall WM, O'Sullivan B, Ozyar E, Peters LJ, Rosenthal DI, Soong YL, Tao Y, Yom SS, Wee JT. International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma. Radiother Oncol 2018; 126:25-36. [DOI: 10.1016/j.radonc.2017.10.032] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 12/09/2022]
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Pacyniak J. Analytic derivation of central axis percent depth dose calculations in transition zones with loss of electronic equilibrium. INTERNATIONAL JOURNAL OF CANCER THERAPY AND ONCOLOGY 2016. [DOI: 10.14319/ijcto.43.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sri Krishna G, Akula R. DVH Analysis of Cobalt-60 treatment plans incorporating a recently developed MLC. INTERNATIONAL JOURNAL OF CANCER THERAPY AND ONCOLOGY 2016. [DOI: 10.14319/ijcto.43.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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