Cozzi L, Fogliata A, Thompson S, Franzese C, Franceschini D, de Rose F, Tomatis S, Scorsetti M. Critical Appraisal of the Treatment Planning Performance of Volumetric Modulated Arc Therapy by Means of a Dual Layer Stacked Multileaf Collimator for Head and Neck, Breast, and Prostate.
Technol Cancer Res Treat 2019;
17:1533033818803882. [PMID:
30295172 PMCID:
PMC6176542 DOI:
10.1177/1533033818803882]
[Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose:
To ascertain whether a new delivery system (the Halcyon system) equipped with
dual-layer stacked multileaf collimator operating in a mode, which allows
independent, fully interdigitating motion of both layers and 6 flattening
filter free energy, could generate plans of high clinical quality compared
to a well-established delivery system with single layer multileaf
collimator.
Methods:
Twenty patients in each of the 3 groups (advanced head and neck, breast, and
high-risk prostate) were selected for an in silico planning study. For each
patient, reference plans were developed for volumetric modulated arc therapy
technique with 6 MV photon beams from a TrueBeam linear accelerator and
compared against the corresponding plans for the Halcyon system. Plan
comparison was performed in terms of dose volume histogram quantitative
analysis.
Results:
Concerning the planning target volumes, with identical dose calculation and
optimization algorithms and with identical planning techniques, no
clinically relevant difference in coverage (D98%), hot spot
(D2%), or homogeneity was observed. Similarly, for all the
organs at risk, the dosimetric findings showed that (1) all planning
constraints were met by the 2 delivery systems and (2) although statistical
significant differences were reported for most of the parameters but none of
these were judged of potential clinical relevance.
Conclusion:
The data presented confirmed that the new delivery system can generate
treatment plans for volumetric modulated arc therapy with the same
dosimetric quality of what is achievable with other systems routinely used
in the clinics without significantly changing the current practice.
Additional studies which customize the optimization parameters for each
delivery device would complement the spectrum of investigations.
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