Tangential Volumetric Modulated Arc Therapy for Locally Advanced Breast Cancer.

Cardiovascular toxicity from breast radiation therapy (RT) is a concern to patients and providers. Herein, we present a cardiac-sparing strategy using tangential volumetric modulated arc therapy (tVMAT) in comparison with standard 3-dimensional conformal RT. Ten patients with left-sided breast cancer previously treated with adjuvant RT covering the breast, as well as the axillary and supraclavicular nodal regions, were selected for the study.

MVCT versus kV-CBCT for targets subject to respiratory motion: A phantom study.

The use of kilovoltage cone-beam computed tomography (kV-CBCT) or megavoltage computed tomography (MVCT) for image guidance prior to lung stereotactic body radiation therapy (SBRT) is common clinical practice. We demonstrate that under equivalent respiratory conditions, image guidance using both kV-CBCT and MVCT may result in the inadequate estimation of the range of target motion under free-breathing (FB) conditions when standard low-density window and levels are used. Two spherical targets within a respiratory motion phantom were imaged using both long-exhale (LE) and sinusoidal respiratory traces.

Stereotactic radiosurgery commissioning and QA test cases-A TG-119 approach for Stereotactic radiosurgery.

Purpose: To develop a standardized set of representative clinical treatment cases that pose a range of optimization problems for evaluating the plan quality and dosimetric accuracy within the commissioning process for linac-based stereotactic radiosurgery (SRS).

Methods: Five test cases with increasing complexity were created to validate delivery accuracy in SRS commissioning similar to the approach used by AAPM TG-119 in developing a test suite for IMRT commissioning. Standardized structure sets, planning goals, and delivery requirements were specified for each case including a small sphere target, irregular target, irregular target placed off-axis, multi-target, and abutting organs-at-risk (OARs).