Dynamic conical conformal radiotherapy using a C-arm–mounted accelerator: dose distribution and clinical application

Abstract

Purpose The aim of this study was to solve anisotropy in the dose distributions from rotational conformal radiotherapy (RCRT) by using a C-arm–mounted accelerator. Methods and materials The linac head was designed to move along the C-arm with a maximum angle of 60° (from a vertical position toward the gantry). Simultaneous rotation of the gantry creates a dynamic conical irradiation technique. Dynamic conical conformal radiation therapy (Dyconic CRT) was developed by combining the technique with continuous motion of a multileaf collimator. Dose distributions were measured in phantoms using film densitometry and compared with conventional RCRT. Dose distributions in actual radiation therapy patients are also presented. Results Dyconic CRT enabled the precise delivery of noncoplanar beams without rotating the table. The measurements showed that three-dimensionally isotropic dose falloff was achieved with Dyconic CRT. Dose inhomogeneity in the sagittal direction with Dyconic CRT was compensated for by use of wedge filters. Conclusions The drawbacks of the dose distributions produced by RCRT were overcome with the use of Dyconic CRT.