Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

The Dosimetric Comparison of Different SBRT Techniques for Treatment of Liver Cancer Using Flattened and Flattening Filter Free Beam

Document Type : Original Paper

Authors
SURESH T 1
Saminathan MADESWARAN 2
1 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
2 Centre for Functional Materials, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu, India
10.22038/ijmp.2022.63812.2090
Abstract
Introduction:To compare the three-dimensional conformal radiotherapy (3DCRT), dynamic conformal arc therapy (DCA), and volumetric modulated arc therapy (VMAT) in stereotactic body radiation therapy (SBRT) of liver cases using 6MV and 10 MV flattened beam (FB) and flattening filter-free beam (FFFB).
Material and Methods:Twenty liver SBRT patients were selected. The dose prescription was 40 Gy delivered in 5 fractions. 3DCRT, DCA and VMAT planning was performed using 6 MV FB, 6 MV FFFB, 10 MV FB and 10 MV FFFB. Planning target volume (PTV) coverage, organs at risk (OARs) doses, monitor units (MU), and beam on time (BOT) were noted.
Results:VMAT plan produces better PTV coverage in the D98% and D95% region. 6 MV and 10 MV VMAT FB and FFFB reduced the D700cc, V10Gy, and Dmean of the liver minus gross tumor volume region compared to 3DCRT and DCA plans. FFFB in combination with VMAT producing highly conformal plan (Conformit index=1.19), better conformity number (CN=0.85), and lowering Paddick gradient index (GIpad=3.29) in comparison to 3DCRT and DCA. The FFFB needs higher monitor units to achieve the plan in all the techniques. FFFB reduces the BOT, body-PTV mean dose in the non-tumour volume.
Conclusion: VMAT combined with FFFB will produce a highly conformal plan, spare the OAR’s, deliver fast and dose fall off in the body-PTV region is more as compared to 3DCRT and DCA. The VMAT will more advantage to treat the multiple lesions simultaneously and reducing the intra-fraction motion error in liver SBRT.
Keywords
Liver SBRT
Flattened Beam
Flattening Filter Free Beam
Subjects
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Iranian Journal of Medical Physics
Volume 19, Issue 6
November and December 2022
Pages 371-382

  • Receive Date 17 February 2022
  • Revise Date 12 May 2022
  • Accept Date 15 May 2022