Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation

Sarah O S Osman, Prakash Jeevanandam, Nithya Kanakavelu, Denise M Irvine, Ciara A Lyons, Suneil Jain, Alan R Hounsell, Conor K McGarry

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: The purpose of this study is to find the optimal planning settings for prostate SABR-VMAT for high-risk prostate cancer patients irradiated to prostate only (PO) or prostate and pelvic lymph nodes (PPLN).

METHODS: For 10 patients, plans using 6MV flattened, flattening-filter-free (FFF) 6MV (6 F) and FFF 10MV (10 F) photon beams with full and partial arc arrangements were generated and compared. The prescribed dose was 40Gy to the prostate with 25Gy to the PLN in 5 fractions. Plans were then evaluated for PTV coverage, dose fall-off, and OAR doses. The number of monitor units and the treatment delivery times were also compared. Statistical differences were evaluated using a paired sample Wilcoxon signed rank test with a significance level of 0.05%.

RESULTS: A total of 150 plans were generated for this study. Acceptable PO plans were obtained using single arcs, while two arcs were necessary for PPLN. All plans were highly conformal (CI ≥1.3 and CN ≥0.90) with no significant differences in the PTV dose coverage. 6MV plans required significantly longer treatment time and had higher dose spillage compared to FFF plans. Superior plans were obtained using 10 F 300° partial arcs for PO with the lowest rectal dose, dose spillage and the shortest treatment times. For PPLN, 6 F and 10 F plans were equivalent.

CONCLUSIONS: SABR-VMAT with FFF photon beams offers a clear benefit with respect to shorter treatment delivery times and reduced dose spillage. Class solutions using a single 10 F 300° arc for PO and two 10 F or 6 F partial 300° arcs for PPLN are proposed.

Original languageEnglish
Article number155
Number of pages13
JournalRadiation oncology (London, England)
Volume11
DOIs
Publication statusPublished - 24 Nov 2016

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Prostate
Prostatic Neoplasms
Lymph Nodes
Photons
Therapeutics
Nonparametric Statistics

Keywords

  • High-risk prostate cancer
  • SABR
  • VMAT
  • Flattening-filter-free (FFF)
  • Pelvic lymph nodes irradiation

Cite this

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title = "Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation",
abstract = "BACKGROUND: The purpose of this study is to find the optimal planning settings for prostate SABR-VMAT for high-risk prostate cancer patients irradiated to prostate only (PO) or prostate and pelvic lymph nodes (PPLN).METHODS: For 10 patients, plans using 6MV flattened, flattening-filter-free (FFF) 6MV (6 F) and FFF 10MV (10 F) photon beams with full and partial arc arrangements were generated and compared. The prescribed dose was 40Gy to the prostate with 25Gy to the PLN in 5 fractions. Plans were then evaluated for PTV coverage, dose fall-off, and OAR doses. The number of monitor units and the treatment delivery times were also compared. Statistical differences were evaluated using a paired sample Wilcoxon signed rank test with a significance level of 0.05{\%}.RESULTS: A total of 150 plans were generated for this study. Acceptable PO plans were obtained using single arcs, while two arcs were necessary for PPLN. All plans were highly conformal (CI ≥1.3 and CN ≥0.90) with no significant differences in the PTV dose coverage. 6MV plans required significantly longer treatment time and had higher dose spillage compared to FFF plans. Superior plans were obtained using 10 F 300° partial arcs for PO with the lowest rectal dose, dose spillage and the shortest treatment times. For PPLN, 6 F and 10 F plans were equivalent.CONCLUSIONS: SABR-VMAT with FFF photon beams offers a clear benefit with respect to shorter treatment delivery times and reduced dose spillage. Class solutions using a single 10 F 300° arc for PO and two 10 F or 6 F partial 300° arcs for PPLN are proposed.",
keywords = "High-risk prostate cancer , SABR , VMAT , Flattening-filter-free (FFF) , Pelvic lymph nodes irradiation",
author = "Osman, {Sarah O S} and Prakash Jeevanandam and Nithya Kanakavelu and Irvine, {Denise M} and Lyons, {Ciara A} and Suneil Jain and Hounsell, {Alan R} and McGarry, {Conor K}",
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language = "English",
volume = "11",
journal = "Radiation Oncology",
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publisher = "BioMed Central",

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Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation. / Osman, Sarah O S; Jeevanandam, Prakash; Kanakavelu, Nithya; Irvine, Denise M; Lyons, Ciara A; Jain, Suneil; Hounsell, Alan R; McGarry, Conor K.

In: Radiation oncology (London, England), Vol. 11, 155, 24.11.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Class solutions for SABR-VMAT for high-risk prostate cancer with and without elective nodal irradiation

AU - Osman, Sarah O S

AU - Jeevanandam, Prakash

AU - Kanakavelu, Nithya

AU - Irvine, Denise M

AU - Lyons, Ciara A

AU - Jain, Suneil

AU - Hounsell, Alan R

AU - McGarry, Conor K

PY - 2016/11/24

Y1 - 2016/11/24

N2 - BACKGROUND: The purpose of this study is to find the optimal planning settings for prostate SABR-VMAT for high-risk prostate cancer patients irradiated to prostate only (PO) or prostate and pelvic lymph nodes (PPLN).METHODS: For 10 patients, plans using 6MV flattened, flattening-filter-free (FFF) 6MV (6 F) and FFF 10MV (10 F) photon beams with full and partial arc arrangements were generated and compared. The prescribed dose was 40Gy to the prostate with 25Gy to the PLN in 5 fractions. Plans were then evaluated for PTV coverage, dose fall-off, and OAR doses. The number of monitor units and the treatment delivery times were also compared. Statistical differences were evaluated using a paired sample Wilcoxon signed rank test with a significance level of 0.05%.RESULTS: A total of 150 plans were generated for this study. Acceptable PO plans were obtained using single arcs, while two arcs were necessary for PPLN. All plans were highly conformal (CI ≥1.3 and CN ≥0.90) with no significant differences in the PTV dose coverage. 6MV plans required significantly longer treatment time and had higher dose spillage compared to FFF plans. Superior plans were obtained using 10 F 300° partial arcs for PO with the lowest rectal dose, dose spillage and the shortest treatment times. For PPLN, 6 F and 10 F plans were equivalent.CONCLUSIONS: SABR-VMAT with FFF photon beams offers a clear benefit with respect to shorter treatment delivery times and reduced dose spillage. Class solutions using a single 10 F 300° arc for PO and two 10 F or 6 F partial 300° arcs for PPLN are proposed.

AB - BACKGROUND: The purpose of this study is to find the optimal planning settings for prostate SABR-VMAT for high-risk prostate cancer patients irradiated to prostate only (PO) or prostate and pelvic lymph nodes (PPLN).METHODS: For 10 patients, plans using 6MV flattened, flattening-filter-free (FFF) 6MV (6 F) and FFF 10MV (10 F) photon beams with full and partial arc arrangements were generated and compared. The prescribed dose was 40Gy to the prostate with 25Gy to the PLN in 5 fractions. Plans were then evaluated for PTV coverage, dose fall-off, and OAR doses. The number of monitor units and the treatment delivery times were also compared. Statistical differences were evaluated using a paired sample Wilcoxon signed rank test with a significance level of 0.05%.RESULTS: A total of 150 plans were generated for this study. Acceptable PO plans were obtained using single arcs, while two arcs were necessary for PPLN. All plans were highly conformal (CI ≥1.3 and CN ≥0.90) with no significant differences in the PTV dose coverage. 6MV plans required significantly longer treatment time and had higher dose spillage compared to FFF plans. Superior plans were obtained using 10 F 300° partial arcs for PO with the lowest rectal dose, dose spillage and the shortest treatment times. For PPLN, 6 F and 10 F plans were equivalent.CONCLUSIONS: SABR-VMAT with FFF photon beams offers a clear benefit with respect to shorter treatment delivery times and reduced dose spillage. Class solutions using a single 10 F 300° arc for PO and two 10 F or 6 F partial 300° arcs for PPLN are proposed.

KW - High-risk prostate cancer

KW - SABR

KW - VMAT

KW - Flattening-filter-free (FFF)

KW - Pelvic lymph nodes irradiation

U2 - 10.1186/s13014-016-0730-7

DO - 10.1186/s13014-016-0730-7

M3 - Article

C2 - 27881187

VL - 11

JO - Radiation Oncology

JF - Radiation Oncology

SN - 1748-717X

M1 - 155

ER -