Volumetric Modulated Arc Therapy (VMAT): A Modern Radiotherapy Technique - A Single Institutional Experience

Overview

Journal Pak J Med Sci

Specialty General Medicine

Date 2021 Mar 8

PMID 33679913

Citations 3

Authors

Azhar Rashid

Zaeem Ahmad

Muhammad Ali Memon

Abdul Sattar M Hashim

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate VMAT plans for conformity and homogeneity of radiation dose to the target in order to share our experience as a pioneering institute to use VMAT technology in Pakistan.

Methods: Since December 2014 to January 2018, 530 patients of various anatomical sites were treated by VMAT technique at Neurospinal Cancer Care Institute (NCCI) Karachi Pakistan. ERGO++ planning system (Version 1.7.2) was used to develop VMAT plans with single or multiple arcs by the rotation of couch and gantry. The plans were evaluated by calculating Conformity Index (CI) and Homogeneity Index (HI) and critical organ (OARs) doses of individual tumor sites.

Results: The average CI of various sites was 1.4 (range: 1.0-2.0) and average HI of various sites was 1.20 (range: 1.07-1.374), respective critical organ doses were adequately achieved.

Conclusions: VMAT treatment planning technique showed good conformal and homogeneous target coverage with sparing of organs at risk and reduced treatment delivery time. With these features, safety of VMAT technique may allow its routine clinical use, though it is still under investigation in many areas.

Citing Articles

Real-time CBCT imaging and motion tracking via a single arbitrarily-angled x-ray projection by a joint dynamic reconstruction and motion estimation (DREME) framework.

Shao H, Mengke T, Pan T, Zhang Y Phys Med Biol. 2025; 70(2.

PMID: 39746309 PMC: 11747166. DOI: 10.1088/1361-6560/ada519.

Real-time CBCT Imaging and Motion Tracking via a Single Arbitrarily-angled X-ray Projection by a Joint Dynamic Reconstruction and Motion Estimation (DREME) Framework.

Shao H, Mengke T, Pan T, Zhang Y ArXiv. 2024; .

PMID: 39398221 PMC: 11469417.

New Frontiers in Locally Advanced Cervical Cancer Treatment.

Massobrio R, Bianco L, Campigotto B, Attianese D, Maisto E, Pascotto M J Clin Med. 2024; 13(15).

PMID: 39124724 PMC: 11312973. DOI: 10.3390/jcm13154458.

Advances in Molecular Pathology, Diagnosis and Treatment of Spinal Cord Astrocytomas.

Zhao Z, Song Z, Wang Z, Zhang F, Ding Z, Fan T Technol Cancer Res Treat. 2024; 23:15330338241262483.

PMID: 39043042 PMC: 11271101. DOI: 10.1177/15330338241262483.

References

Takahashi S . Conformation radiotherapy. Rotation techniques as applied to radiography and radiotherapy of cancer. Acta Radiol Diagn (Stockh). 1965; :Suppl 242:1+. View

Oliver M, Ansbacher W, Beckham W . Comparing planning time, delivery time and plan quality for IMRT, RapidArc and Tomotherapy. J Appl Clin Med Phys. 2009; 10(4):117-131. PMC: 5720582. DOI: 10.1120/jacmp.v10i4.3068. View

Sheu T, Briere T, Olanrewaju A, McAleer M . Intensity Modulated Radiation Therapy Versus Volumetric Arc Radiation Therapy in the Treatment of Glioblastoma-Does Clinical Benefit Follow Dosimetric Advantage?. Adv Radiat Oncol. 2019; 4(1):50-56. PMC: 6349632. DOI: 10.1016/j.adro.2018.09.010. View

Hanna S, Mancini A, Dal Col A, Asso R, Neves-Junior W . Frameless Image-Guided Radiosurgery for Multiple Brain Metastasis Using VMAT: A Review and an Institutional Experience. Front Oncol. 2019; 9:703. PMC: 6693418. DOI: 10.3389/fonc.2019.00703. View

Kataria T, Sharma K, Subramani V, Karrthick K, Bisht S . Homogeneity Index: An objective tool for assessment of conformal radiation treatments. J Med Phys. 2013; 37(4):207-13. PMC: 3532749. DOI: 10.4103/0971-6203.103606. View

Otto K . Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys. 2008; 35(1):310-7. DOI: 10.1118/1.2818738. View

Li S, Zhou Q, Shen L, Li H, Li Z, Yang Z . Dosimetric Comparisons of Volumetric Modulated Arc Therapy and Tomotherapy for Early T-Stage Nasopharyngeal Carcinoma. Biomed Res Int. 2018; 2018:2653497. PMC: 6008744. DOI: 10.1155/2018/2653497. View

Macchia G, Deodato F, Cilla S, Cammelli S, Guido A, Ferioli M . Volumetric modulated arc therapy for treatment of solid tumors: current insights. Onco Targets Ther. 2017; 10:3755-3772. PMC: 5538686. DOI: 10.2147/OTT.S113119. View

Feuvret L, Noel G, Mazeron J, Bey P . Conformity index: a review. Int J Radiat Oncol Biol Phys. 2006; 64(2):333-42. DOI: 10.1016/j.ijrobp.2005.09.028. View

10.

Khan M, Jiang R, Kiciak A, Ur Rehman J, Afzal M, Chow J . Dosimetric and radiobiological characterizations of prostate intensity-modulated radiotherapy and volumetric-modulated arc therapy: A single-institution review of ninety cases. J Med Phys. 2016; 41(3):162-8. PMC: 5019034. DOI: 10.4103/0971-6203.189479. View

11.

Zhang S, Yang R, Shi C, Li J, Zhuang H, Tian S . Noncoplanar VMAT for Brain Metastases: A Plan Quality and Delivery Efficiency Comparison With Coplanar VMAT, IMRT, and CyberKnife. Technol Cancer Res Treat. 2019; 18:1533033819871621. PMC: 6710677. DOI: 10.1177/1533033819871621. View

12.

Kim K, Wee C, Seok J, Hong J, Chung J, Eom K . Hippocampus-sparing radiotherapy using volumetric modulated arc therapy (VMAT) to the primary brain tumor: the result of dosimetric study and neurocognitive function assessment. Radiat Oncol. 2018; 13(1):29. PMC: 5819694. DOI: 10.1186/s13014-018-0975-4. View

13.

Teoh M, Clark C, Wood K, Whitaker S, Nisbet A . Volumetric modulated arc therapy: a review of current literature and clinical use in practice. Br J Radiol. 2011; 84(1007):967-96. PMC: 3473700. DOI: 10.1259/bjr/22373346. View

14.

Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M . Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes?. Radiother Oncol. 2009; 93(2):259-65. DOI: 10.1016/j.radonc.2009.08.015. View

15.

Atiq A, Atiq M, Iqbal K, Sial M, Altaf S, Shamsi Q . A comparative study of RapidArc and intensity-modulated radiotherapy plan quality for cervical cancer treatment. Indian J Cancer. 2018; 55(1):74-79. DOI: 10.4103/ijc.IJC_609_17. View

16.

Timmerman R . An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol. 2008; 18(4):215-22. DOI: 10.1016/j.semradonc.2008.04.001. View

17.

. Intensity-modulated radiotherapy: current status and issues of interest. Int J Radiat Oncol Biol Phys. 2001; 51(4):880-914. DOI: 10.1016/s0360-3016(01)01749-7. View

18.

Yu C . Intensity-modulated arc therapy with dynamic multileaf collimation: an alternative to tomotherapy. Phys Med Biol. 1995; 40(9):1435-49. DOI: 10.1088/0031-9155/40/9/004. View

19.

Fareed M, Jamshed A, Butt S, Shaukat F, Nguyen P, Ngwa W . Evolution of Radiation Oncology in Pakistan. Int J Radiat Oncol Biol Phys. 2019; 105(1):11-16. DOI: 10.1016/j.ijrobp.2019.04.016. View

20.

Ruggieri R, Naccarato S, Mazzola R, Ricchetti F, Corradini S, Fiorentino A . Linac-based VMAT radiosurgery for multiple brain lesions: comparison between a conventional multi-isocenter approach and a new dedicated mono-isocenter technique. Radiat Oncol. 2018; 13(1):38. PMC: 5836328. DOI: 10.1186/s13014-018-0985-2. View