VMAT and step-and-shoot IMRT in head and neck cancer: a comparative plan analysis.

Purpose: Rotational IMRT is a new technique, whose value still has to be assessed. We evaluated its adequacy for the treatment of head and neck (H&N) cancer compared to the well-established step-and-shoot IMRT.

Materials And Methods: A total of 15 patients, who were treated with either IMRT (13 patients) or VMAT (2 patients) in the H&N region, were chosen.

Stereotactic fractionated radiotherapy for Klatskin tumours.

Background And Purpose: In spite of various efforts perihilar cholangiocellular carcinoma (Klatskin tumour) has still a bad prognosis. The treatment of patients with inoperable Klatskin tumours by stereotactic fractionated radiotherapy (SFRT) was analysed retrospectively. PATIENTS, METHODS AND MATERIALS: In our department 13 patients were treated for Klatskin tumours by SFRT (32-56 Gy, 3 x 4 Gy/week) from 1998 to 2008.

First results of the federal quality assurance group ("Arztliche Stelle") in radiotherapy in Baden-Württemberg: part 2.

Purpose: Part 2 of this study presents the results of the clinical audits of the "Arztliche Stelle" (AS) concerning process quality in the radiation therapy units in Baden-Württemberg, Germany.

Material And Methods: The process quality of nine main test groups (laws, organizations, technical equipment, GMP [Good Medical Practice] principles, radiotherapy, radiation procedure, follow-up, discharge report, physics) were questioned by the AS commission and evaluated in a four-stage classification (1-4; none to grave deficiencies).

Results: In 18 institutes (81%), the medical and physical-technical inspection, including radiation protection for patients and staff, revealed very high to high quality, safe treatment commensurate with current standards was guaranteed once the suggestions for improvement given by the experts had been implemented.

[First results of the federal quality assurance group ("Arztliche Stelle") in radiotherapy in baden-württemberg: part 1].

Purpose: To evaluate the structure quality (medical staff, linear accelerators, and patients) of radiotherapy units based on the clinical audits by the "Arztliche Stelle" (this institution is based on federal German law) in Baden-Württemberg.

Material And Methods: External audits (performed by at least two radiation oncologists, one radiation physicist, and a member of the administration) of recently completed charts by designated reviewers using appropriate checklists developed by the federal task group ("Arztliche Stelle") were used.

Results: In the interval from 2005 to 2007, 60 linear accelerators in 24 radiotherapy units served a population of approximately 10.

On the accuracy of isocenter verification with kV imaging in stereotactic radiosurgery.

Background And Purpose: Modern medical linear accelerators (linacs) are equipped with X-ray systems, which allow to check the patient's position just prior to treatment. Their usefulness for stereotactic radiosurgery (SRS) depends on how accurately they allow to determine the deviation between the actual and planned isocenter positions. This accuracy was investigated with measurements using two different phantoms (Figures 1 and 2).

Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: a case report.

In view of the poor prognosis of patients with cholangiocarcinoma (CCC), there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. Radiotherapy is an effective alternative to surgery for hilar CCC (Klatskin tumors) if an adequate radiation dose can be delivered to the liver hilus.

Physical and technical quality assurance in the CHARTWEL-Bronchus trial.

Background: On-site physical quality assurance (QA) was performed in the participating centers of the CHARTWEL-Bronchus trial to ensure that physical and technical treatment parameters correspond with the requirements of this trial.

Material And Methods: Questionnaires were sent to the clinics to obtain information on the equipment and in-house QA policies. In addition, two phantoms with drillings for an ionization chamber were shipped with detailed instructions for CT-based treatment planning of a fixed field (RW3 phantom) and a standardized isocentric 3-field technique (Rando humanoid phantom).

[Long term registration of linear accelerator parameters for quality assurance in stereotaxic radiosurgery].

Long-term observations of mechanical parameters have been performed in Freiburg for the last 7 years within the quality assurance of stereotactic irradiation at linear accelerators. The deviations between the laser indication and the position of the beam isocentre are recorded, as well as parameters for the stability of the couch rotation and the additional devices for patient adjustment and beam collimation. The deviations are used for the correction of the calculated isocentre coordinates.