Hybrid planning techniques for hypofractionated whole-breast irradiation using flattening filter-free beams.

Objective: The aim of this study was to assess the feasibility of flattening filter-free (FFF) photon beams in hybrid intensity-modulated radiation therapy (H-IMRT) and hybrid volumetric modulated arc therapy (H-VMAT) for left-sided whole-breast radiation therapy with a boost volume (RT) using a hypofractionated dose regimen.

Patients And Methods: RT plans of 25 patients with left-sided early-stage breast cancer were created with H‑IMRT and H‑VMAT techniques under breath-hold conditions using 6‑MV FFF beams. In hybrid techniques, three-dimensional conformal radiotherapy (3DCRT) plans were kept as base-dose plans for the VMAT and IMRT plans.

Hybrid volumetric modulated arc therapy for whole breast irradiation: a dosimetric comparison of different arc designs.

Purpose: To find an optimal arc design for hybrid volumetric modulated arc therapy (H-VMAT), a combination of conventional 3DCRT and VMAT plans for left-sided whole breast radiation therapy.

Methods And Materials: A total of 26 left-sided early-stage breast cancer patients were selected for this study. To find the superior plan, H-VMAT with three different arc designs including, two partial arcs (2A), four partial arcs (4A) and four tangential arcs (TA) were created for each study case by combining 3DCRT and VMAT with 75% 3DCRT/25% VMAT dose proportion of prescription dose.

Feasibility of MR-only radiation planning for hypofractionated stereotactic radiotherapy of schwannomas using non-coplanar volumetric modulated arc therapy.

Purpose: To compare the dose calculation accuracy of plans done on a CT density-assigned MR image set for hypofractionated stereotactic radiotherapy (HSRT) using volumetric modulated radiation therapy containing non-coplanar beams.

Methods: Eighteen patients diagnosed with schwannoma treated with HSRT were selected retrospectively. These patients underwent planning CT (pCT) for radiation therapy (RT) and contrast-enhanced three-dimensional fast-spoiled gradient-echo image (3D FSPGR) to assist tumor delineation.

Evaluation of beam matching accuracy among six linacs from the same vendor.

The purpose of this study was to evaluate the dosimetric variation among six non-beam-matched Varian linacs using different techniques for the same plans. Six non-beam-matched Varian machines, comprising two Clinac iX, two 600 C/D (Unique), and two True Beam Tx photon 6 MV X-ray devices were acquired. Sixty patients with of head and neck (H&N; 30) and pelvic (30) treatment sites were chosen.

Hybrid volumetric modulated arc therapy for chest wall irradiation: For a good plan, get the right mixture.

Purpose: To find the optimal dose weighting for hybrid volumetric modulated arc therapy (H-VMAT), a combination of conventional 3DCRT and VMAT plans for left sided chest wall and supraclavicular radiation therapy.

Methods & Materials: 20 left-sided breast cancer patients who received adjuvant radiotherapy were considered for this study. To find the optimal weighting, 5 H-VMAT plans were generated for each study case by combining different dose proportions of 3DCRT and VMAT plans including: 90% 3DCRT/10% VMAT, 80% 3DCRT/20% VMAT, 70% 3DCRT/30% VMAT, 60% 3DCRT/40% VMAT, 50% 3DCRT/50% VMAT.

Is the dose distribution distorted in IMRT and RapidArc treatment when patient plans are swapped across beam-matched machines?

The purpose of this study is to evaluate the degree of dose distribution distortion in advanced treatments like IMRT and RapidArc when patient plans are swapped across dosimetrically equivalent so-called "beam-matched" machines. For this purpose the entire work is divided into two stages. At forefront stage all basic beam properties of 6 MV X-rays like PDD, profiles, output factors, TPR20/10 and MLC transmission of two beam-matched machines - Varian Clinac iX and Varian 600 C/D Unique - are compared and evaluated for differences.

Radiation therapy for breast cancer: Literature review.

Concave shape with variable size target volume makes treatment planning for the breast/chest wall a challenge. Conventional techniques used for the breast/chest wall cancer treatment provided better sparing of organs at risk (OARs), with poor conformity and uniformity to the target volume. Advanced technologies such as intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) improve the target coverage at the cost of higher low dose volumes to OARs.

Planning and Dosimetric Study of Volumetric Modulated Arc Based Hypofractionated Stereotactic Radiotherapy for Acoustic Schwannoma--6MV Flattening Filter Free Photon Beam.

Background: The purpose of this study was to assess the dosimetric and clinical feasibility of volumetric modulated arc based hypofractionated stereotactic radiotherapy (RapidArc) treatment for large acoustic schwannoma (AS>10 cc).

Materials And Methods: Ten AS patients were immobilized using BrainLab mask. They were subject to multimodality imaging (magnetic resonance and computed tomography) to contour target and organs at risk (brainstem and cochlea).

Feasibility study of deep inspiration breath-hold based volumetric modulated arc therapy for locally advanced left sided breast cancer patients.

Background: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB).

Materials And Methods: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock.