ArticleRevista da Associacao Medica Brasileira (1992)2025
Evaluating volumetric modulated arc therapy planning efficiency and dosimetric impact on non-contoured organ at risk in whole brain radiotherapy: a focus on oral cavity dose distribution.
Article in Revista da Associacao Medica Brasileira (1992), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe aim of this study was to investigate the dosimetric outcomes and planning efficiency of volumetric modulated arc therapy compared to the field-in-field technique for whole brain radiotherapy, with a focus on the oral cavity as a newly defined organ at risk. The study also evaluates the impact of volumetric modulated arc therapy re-optimization on reducing oral cavity doses while ensuring target coverage.
methodsTreatment plans for 20 technique for whole brain radiotherapy patients treated with volumetric modulated arc therapy were retrospectively analyzed and re-evaluated using field-in-field and volumetric modulated arc therapy re-optimization techniques. Dosimetric parameters, including D2%, D98%, V30(Gy), homogeneity index, and conformity index, were compared for the planning target volume. Mean and maximum doses to the oral cavity and bilateral lenses were assessed.
resultsVolumetric modulated arc therapy provided superior conformity (CI 0.82±0.07) and homogeneity (HI: 1.05±0.00) compared to field-in-field (CI 0.65±0.13, HI: 1.06±0.10) with significant differences (p<0.001). However, volumetric modulated arc therapy resulted in higher mean and maximum oral cavity and lens doses. Volumetric modulated arc therapy re-optimization significantly reduced oral cavity doses (p<0.001) while maintaining similar target coverage and dosimetric performance to volumetric modulated arc therapy.
conclusionsVolumetric modulated arc therapy improves dose conformity and homogeneity compared to field-in-field but increases doses to non-contoured organ at risk. Volumetric modulated arc therapy re-optimization effectively lowers oral cavity doses without compromising target coverage, underscoring the importance of identifying and addressing non-standard organ at risk. These findings highlight volumetric modulated arc therapy's clinical advantages, particularly in high-demand settings, while emphasizing the need for optimizing organ at risk to reduce toxicity.
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