Evaluation of dosimetric implications of Pareto and constrained mode of optimization for Monaco TPS generated VMAT plans in post operated carcinoma of the left breast

• Autorzy: Srivastava Anoop Kumar , Bharati Avinav , Rastogi Madhup , Mishra Surendra Prasad , Khurana Rohini , Hadi Rahat , Gandhi Ajeet Kumar , Mishra Lalatendu

Identyfikatory

DOI

10.2478/pjmpe-2021-0002

• Języki publikacji: EN

Abstrakty

EN

Intensity-modulated radiotherapy (IMRT) is being practiced for the last several years with a special approach for radiation therapy in post-mastectomy breast cancer patients. Meeting the cardiac dose constraints has always been a challenge during radiotherapy planning by both IMRT and VMAT (volumetric modulated arc therapy) of postmastectomy left breast patients. With the advancement in IMRT planning techniques, it has been modified to VMAT with more degrees of freedom for modulation and is being utilised more frequently. This helps in obtaining a suitable plan for achieving both the dose homogeneity in target volume and dose constraints to Organ at Risk (OAR). 10 Patients with carcinoma of the left breast (post-mastectomy) were selected for this study. VMAT treatment plans for these patients were generated for 6 MV photons on the Monaco treatment planning system (TPS) using two types of optimization modes i.e. Pareto and Constrained mode available in Monaco TPS. For comparative dosimetric evaluation of the efficacy of these two types of optimization modes similar calculation algorithms, calculation grids, arcs, and beam sequencing parameters were used for generating treatment plans. The dosimetric quantities such as volume receiving more than 95% of the prescribed dose (V₉₅), volume receiving more than 107% of the prescribed dose (V₁₀₇) and Maximum dose (D_max) for target volume, mean dose (D_mean) for heart, volume receiving more than 30 Gy (V₃₀) volume receiving more than 20 Gy (V₂₀) volume receiving more than 5 Gy (V₅) for ipsilateral lung and total monitor units delivered were analysed for both optimization modes. A judicious mix of multiple planning parameters and variables using these two modes of optimization was applied and recorded. Both optimization modes yielded similar outcomes. However, Pareto mode has shown better coverage for planning target volume (PTV) with comparable doses to OARs.

Słowa kluczowe

EN

VMAT; optimization; constrained; Pareto; Monte-Carlo

• Wydawca: Polskie Towarzystwo Fizyki Medycznej ; De Gruyter
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2021
• Tom: Vol. 27, Iss. 1
• Strony: 11--18
• Opis fizyczny: Bibliogr. 14 poz., rys., tab.

Twórcy

autor

Srivastava Anoop Kumar

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Bharati Avinav

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Rastogi Madhup

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Mishra Surendra Prasad

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Khurana Rohini

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Hadi Rahat

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Gandhi Ajeet Kumar

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

autor

Mishra Lalatendu

• Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow India-226010

Bibliografia

• 1. Bogue J, Wan J, Lavey RS, Parsai EI. Dosimetric comparison of VMAT with integrated skin flash to 3D field-in-field tangents for left breast irradiation. J Appl Clin Med Phys. 2019;20(2):24-29. https://doi.org/10.1002/acm2.12527
• 2. Dumane VA, Lo YC, Green S. Combination of volumetric-modulated arc therapy (VMAT) and partially wide tangents (PWT) for improved organ sparing in a left-sided and right-sided breast cancer case receiving regional nodal irradiation (RNI): A technical note. Appl Rad Oncol. 2018;7(2):31-38.
• 3. Byrne M, Archibald-Heeren B, Hu Y, et al. Comparison of semi-automated tangential VMAT with 3DCRT for breast or chest wall and regional nodes. J Appl Clin Med Phys. 2018;19(5):684-693. https://doi.org/10.1002/acm2.12442
• 4. Sudha SP, Seenisamy R, Bharadhwaj K. Comparison of dosimetric parameters of volumetric modulated arc therapy and three dimensional conformal radiotherapy in post mastectomy patients with carcinoma breast. J Can Res Ther. 2018;14(5):1005-1009. https://doi.org/10.4103/0973-1482.189400
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• 7. Craft D. Multi-criteria optimization methods in radiation therapy planning: a review of technologies and directions. arXiv:1305.1546v1
• 8. Craft D, Bortfeld T. How many plans are needed in an IMRT multi- objective plan database? Phys Med Biol. 2008;53(11):2785-2796. https://doi.org/10.1088/0031-9155/53/11/002
• 9. Craft D, McQuaid D, Wala J, et al. Multicriteria VMAT optimization. Med Phys. 2012;39(2):686-696. https://doi.org/10.1118/1.3675601
• 10. RTOG Oncology Group. Breast Cancer Atlas for Radiation Therapy Planning: Consensus Definitions. https://www.nrgoncology.org/Portals/0/Scientific%20Program/CIRO/Atlases/BreastCancerAtlas_corr.pdf?ver=2018-04-18-144201-270
• 11. Pyshniak V, Fotina I, Zverava A,. Efficiency of biological versus physical optimization for single-arc VMAT for prostate and head and neck cases. J Appl Clin Med Phys. 2014;15(4):39-53. https://doi.org/10.1120/jacmp.v15i4.4514
• 12. Qi XS, Liu TX, Liu AK, et al. Left-sided breast cancer irradiation using rotational and fixed- field radiotherapy. Med Dosim. 2014;(39):227-234. https://doi.org/10.1016/j.meddos.2014.02.005
• 13. Lee CH, Jhang ZR, Yeh SA, et al. A planning study for evaluation of feasibility and benefit of generalized equivalent uniform doseassisted optimization in volumetric-modulated arc therapy for recurrent head and neck cancer. Ther Radiol Oncol. 2018;2:36. https://doi.org/10.21037/tro.2018.08.01
• 14. Semenenko VA, Reitz B, Day E, et al. Evaluation of a commercial biologically based IMRT treatment planning system. Med Phys. 2008;35(12):5851-5860. https://doi.org/10.1118/1.3013556

Uwagi

Opracowanie rekordu ze środków MNiSW, umowa Nr 461252 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2021).