Abstract
BackgroundThere as yet exists no systematic planning study investigating the novel mARC rotational radiotherapy technique, which is conceptually different from VMAT. We therefore present a planning study for prostate cancer, comparing mARC with IMRT treatment at the same linear accelerator equipped with flat and flattening-filter-free (FFF) photon energies.MethodsWe retrospectively re-contoured and re-planned treatment plans for 10 consecutive prostate cancer patients. Plans were created for a Siemens Artiste linear accelerator with flat 6 MV and FFF 7 MV photons, using the Prowess Panther treatment planning system. mARC and IMRT plans were compared with each other considering indices for plan quality and dose to organs at risk. All plans were exported to the machine and irradiated while measuring scattered dose by thermoluminescent dosimeters placed on an anthropomorphic phantom. Treatment times were also measured and compared.ResultsAll plans were found acceptable for treatment. There was no marked preference for either technique or energy from the point of view of target coverage and dose to organs at risk. Scattered dose was significantly decreased by the use of FFF energies. While mARC and IMRT plans were of very similar overall quality, treatment time could be markedly decreased both by the use of mARC and FFF energy.ConclusionsHighly conformal treatment plans could be created both by the use of flat 6 MV and FFF 7 MV energy, using IMRT or mARC. For all practical purposes, the FFF 7 MV energy and mARC plans are acceptable for treatment, a combination of both allowing a drastic reduction in treatment time from over 5 minutes to about half this value.
Highlights
There as yet exists no systematic planning study investigating the novel mARC rotational radiotherapy technique, which is conceptually different from VMAT
The dosimetric accuracy has been assessed by various methods and first patient treatment has been reported [3,4], no systematic planning studies have yet been carried out to assess the quality of mARC treatment as compared with intensity-modulated radiation therapy (IMRT) delivered at the same linear accelerator
Gross tumor volume (GTV), clinical target volume (CTV), planning target volume (PTV) and normal tissues were outlined on all Computed tomography (CT) slices in which the structures existed
Summary
There as yet exists no systematic planning study investigating the novel mARC rotational radiotherapy technique, which is conceptually different from VMAT. We present a planning study for prostate cancer, comparing mARC with IMRT treatment at the same linear accelerator equipped with flat and flattening-filter-free (FFF) photon energies. The dosimetric accuracy has been assessed by various methods and first patient treatment has been reported [3,4], no systematic planning studies have yet been carried out to assess the quality of mARC treatment as compared with IMRT delivered at the same linear accelerator. We present a planning study for prostate cancer with mARC for a Siemens Artiste machine equipped with flat 6 MV and flatteningfilter-free (FFF) 7 MV energies. The mARC technique is a Siemens Artiste specific modality and primarily interesting for Siemens customers, we hope that the comparison of the flat and FFF beam lines, both for mARC and IMRT treatment, will be useful for a wide range of readers
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