ArticleJournal of applied clinical medical physics2019
Improving treatment efficiency via photon optimizer (PO) MLC algorithm for synchronous single-isocenter/multiple-lesions VMAT lung SBRT.
Article in Journal of applied clinical medical physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Advancing stereotactic body radiotherapy through off-axis beam optimization to enable safer treatment of multi-isocenter coplanar targets.Physics and imaging in radiation oncology · 2026Article
- Evaluation of plan complexity and dosimetric plan quality of total marrow and lymphoid irradiation using volumetric modulated arc therapy.Journal of applied clinical medical physics · 2023Article
- Progressive resolution optimizer (PRO) predominates over photon optimizer (PO) in sparing of spinal cord for spine SABR VMAT plans.BMC cancer · 2023Article
- Evaluation of improvements in plan quality with Photon Optimizer v16.1 for single brain lesion SRS treatment.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2023Article
- Knowledge-based planning for multi-isocenter VMAT total marrow irradiation.Frontiers in oncology · 2022Article
- Effect of treatment planning system parameters on beam modulation complexity for treatment plans with single-layer multi-leaf collimator and dual-layer stacked multi-leaf collimator.The British journal of radiology · 2021Article
- Risk of target coverage loss for stereotactic body radiotherapy treatment of synchronous lung lesions via single-isocenter volumetric modulated arc therapy.Journal of applied clinical medical physics · 2021Article
- A novel and clinically useful dynamic conformal arc (DCA)-based VMAT planning technique for lung SBRT.Journal of applied clinical medical physics · 2020Article
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Abstract
purposeElderly patients with multiple primary or oligometastases (<5 lesions) lesions with associated co-morbidities may not retain their treatment position for the traditional long SBRT treatment time with individual isocenters for each lesion. Treating multiple lesions synchronously using a single-isocenter volumetric arc therapy (VMAT) plan would be more efficient with the use of the most recently adopted photon optimizer (PO) MLC algorithm and improve the patient comfort. Herein, we quantified the clinical performance of PO versus its predecessor progressive resolution optimizer (PRO) algorithm for single-isocenter/multiple-lesions VMAT lung SBRT. MATERIALS AND
methodsFourteen patients with metastatic non-small-cell lung cancer lesions (two to five, both uni- and bilateral lungs) received a highly conformal single-isocenter co/non-coplanar VMAT (2-6 arcs) SBRT treatment plan. Patients were treated with a 6X-FFF beam and Acuros algorithm with a single-isocenter placed between/among the lesions, using PO for MLC optimization. Average isocenter to tumor distance was 5.5 ± 1.9 cm. Mean combined PTV derived from 4D-CT scans was 38.7 ± 22.7 cc. Doses were 54 Gy/50 Gy in 3/5 fractions prescribed to 70%-80% isodose line so that at least 95% of the PTV receives 100% of prescribed dose. Plans were re-optimized using PRO algorithm. Plans were compared via ROTG-0915 protocol criteria for target conformity, heterogeneity and gradient indices, and dose to organs-at-risk (OAR). Additionally, total number of monitor units (MU), modulation factor (MF) and beam-on time were compared.
resultsAll plans met SBRT protocol requirements for target coverage and OAR doses. Comparison of target coverage and dose to the OAR showed no statistical significance between the two plans. PO had 1042 ± 753 (P < 0.001) less MU than PRO resulting in a beam-on time of about 0.75 ± 0.5 min (P < 0.001) less, on average. For similar dose distribution, a significant reduction of beam delivery complexity was observed with PO (average MF = 3.7 ± 0.7) vs PRO MLC algorithm (average MF = 4.4 ± 1.3) (P < 0.001).
conclusionsPO MLC algorithm improved treatment efficiency without compromising plan quality when compared to PRO algorithm for single-isocenter/multi-lesions VMAT lung SBRT. Shorter beam-on time can potentially reduce intrafraction motion errors and improve patient compliance. PO MLC algorithm is recommended for future clinical lung SBRT plan optimization.
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