ArticleJournal of applied clinical medical physics2020
A novel and clinically useful dynamic conformal arc (DCA)-based VMAT planning technique for lung SBRT.
Article in Journal of applied clinical medical physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Assessment of 6MV flattening filter free (FFF) beam commissioning parameters for Versa HD and TrueBeam: A comparison study.Journal of applied clinical medical physics · 2026Article
- Novel DCAT plans in stereotactic body radiotherapy for stage I/II centrally located non-small-cell lung cancer.Scientific reports · 2026Article
- Optimizing lung SBRT delivery: A hybrid approach combining dynamic conformal arc (DCA) and volumetric modulated arc therapy (VMAT) techniques.Journal of applied clinical medical physics · 2025Article
- Comprehensive plan quality assessment of simplified volumetric-modulated arc therapy for lung stereotactic body radiotherapy.Radiological physics and technology · 2025Article
- Clinical Viability of an Active Spot Scanning Beam Delivery System With a Newly Developed Carbon-Ion Treatment Planning System.Advances in radiation oncology · 2024Article
- Feasibility of a Single-Fraction Stereotactic Dose of 30 Gy to Solitary Lung Lesions on Halcyon.Cureus · 2024Article
- Evaluation of flattening-filter-free and flattening filter dosimetric and radiobiological criteria for lung SBRT: A volume-based analysis.Frontiers in oncology · 2023Article
- Automation and integration of a novel restricted single-isocenter stereotactic body radiotherapy (a-RESIST) method for synchronous two lung lesions.Journal of applied clinical medical physics · 2021Article
- An Automated knowledge-based planning routine for stereotactic body radiotherapy of peripheral lung tumors via DCA-based volumetric modulated arc therapy.Journal of applied clinical medical physics · 2021Article
- Novel Clinically Weight-Optimized Dynamic Conformal Arcs (WO-DCA) for Liver SBRT: A Comparison with Volumetric Modulated Arc Therapy (VMAT).Therapeutics and clinical risk management · 2021Article
- Development and clinical validation of a robust knowledge-based planning model for stereotactic body radiotherapy treatment of centrally located lung tumors.Journal of applied clinical medical physics · 2021Article
- Voxel-Level BED Corrected Dosimetric and Radiobiological Assessment of 2 Kinds of Hybrid Radiotherapy Planning Methods for Stage III NSCLC.Technology in cancer research & treatmentArticle
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVolumetric modulated arc therapy (VMAT) is gaining popularity for stereotactic treatment of lung lesions for medically inoperable patients. Due to multiple beamlets in delivery of highly modulated VMAT plans, there are dose delivery uncertainties associated with small-field dosimetry error and interplay effects with small lesions. We describe and compare a clinically useful dynamic conformal arc (DCA)-based VMAT (d-VMAT) technique for lung SBRT using flattening filter free (FFF) beams to minimize these effects. MATERIALS AND
methodsTen solitary early-stage I-II non-small-cell lung cancer (NSCLC) patients were treated with a single dose of 30 Gy using 3-6 non-coplanar VMAT arcs (clinical VMAT) with 6X-FFF beams in our clinic. These clinically treated plans were re-optimized using a novel d-VMAT planning technique. For comparison, d-VMAT plans were recalculated using DCA with user-controlled field aperture shape before VMAT optimization. Identical beam geometry, dose calculation algorithm, grid size, and planning objectives were used. The clinical VMAT and d-VMAT plans were compared via RTOG-0915 protocol compliances for conformity, gradient indices, and dose to organs at risk (OAR). Additionally, treatment delivery efficiency and accuracy were recorded.
resultsAll plans met RTOG-0915 requirements. Comparing with clinical VMAT, d-VMAT plans gave similar target coverage with better target conformity, tighter radiosurgical dose distribution with lower gradient indices, and dose to OAR. Lower total number of monitor units and small beam modulation factor reduced beam-on time by 1.75 min (P < 0.001), on average (maximum up to 2.52 min). Beam delivery accuracy was improved by 2%, on average (P < 0.05) and maximum up to 6% in some cases for d-VMAT plans.
conclusionThis simple d-VMAT technique provided excellent plan quality, reduced intermediate dose-spillage, and dose to OAR while providing faster treatment delivery by significantly reducing beam-on time. This novel treatment planning approach will improve patient compliance along with potentially reducing intrafraction motion error. Moreover, with less MLC modulation through the target, d-VMAT could potentially minimize small-field dosimetry errors and MLC interplay effects. If available, d-VMAT planning approach is recommended for future clinical lung SBRT plan optimization.
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