Abstract
A new irradiation technique, volumetric-modulated Dynamic WaveArc therapy (VMDWAT), based on sequential non-coplanar trajectories, can be performed using the Vero4DRT. This planning study compared the dose distribution and treatment time between single-isocenter volumetric-modulated arc therapy (VMAT) with multiple straight non-coplanar arcs and single-isocenter VMDWAT in patients with two brain metastases. Twenty patients with two planning target volumes exceeding 2.0 cm3 were included. Both VMAT and VMDWAT plans were created with single isocenter and a prescribed dose of 28Gy delivered in five fractions. Target conformity was evaluated using indices modified from the RTOG-CI (mRTOG-CI) and IP-CI (mIP-CI). VMDWAT significantly improved both mRTOG-CI and mIP-CI and reduced the volume of normal brain tissue receiving 25 and 28Gy compared to VMAT. The two modalities did not significantly differ in terms of the volume of normal brain tissue receiving 5, 10, 12, 15, and 20Gy. The mean treatment time was significantly shorter in the VMDWAT group. VMDWAT significantly improved dose distribution in a shorter treatment time compared to VMAT in patients treated for two brain metastases. Single-isocenter VMDWAT may thus be a promising treatment for two brain metastases.
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