Sci-Thur PM: YIS - 03: Comparing 4D-VMAT, Gated-VMAT and 3D-VMAT in SBRT treatment of lung cancer

Medical Physics
E ChinK Otto

Abstract

To evaluate the treatment plan qualities of 4D-VMAT, gated-VMAT and 3D-VMAT in the treatment of non-small cell lung cancer (NSCLC) in stereotactic body radiation therapy (SBRT). 4D-VMAT is a motion compensation strategy that aims to exploit relative target and OAR motion to increase OAR sparing over 3D-VMAT without the long treatment times associated with gated-VMAT. The 4D-VMAT algorithm incorporates the entire patient respiratory cycle and 4D-CT in the optimization process. Resulting treatment plans synchronize the delivery of each MLC aperture to a specific phase of the target motion. Using software developed in Matlab™, SBRT treatment plans for 4D-VMAT, gated-VMAT and 3D-VMAT were generated on 3 patients with NSCLC. Tumour motion ranged from 1.4-3.4 cm. The fractionation scheme was 48Gy in 4 fractions with the GTV receiving 100% of the prescribed dose. For gated-VMAT, the treatment window constrained residual tumour motion to 3 mm or less corresponding to duty cycles of 40-60%. In 3D-VMAT, the ITV was generated by merging the GTV from all phases. A b-spline transformation model was used to register the 4D-CT images and DVHs were calculated from total dose accumulated on the max expiration phase. For the majority of OARs, ga...Continue Reading

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