Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Influence of Segment Shape Optimization Parameter in Radiotherapy Volumetric Modulated Arc Therapy Planning of Cervical Cancer

Document Type : Original Paper

Authors
Nidhi Jain 1
Alok Kumar 2
Ashok Kumar 1
1 Department of Physics, AIAS, Amity University, U.P., India
2 Department of Radiation Oncology, Netaji Subhas Chandra Bose Cancer Hospital and Institute, Kolkata, West Bengal, India
10.22038/ijmp.2023.69271.2220
Abstract
Introduction: The aim of this study is to find out the influence of different Segment shape optimization (SSO) parameters in radiotherapy Volumetric Modulated Arc therapy (VMAT) planning of Cervical Cancer and to find out the optimized value for cervical cancer patients.
Material and Methods: It was a retrospective study of 20 Ca cervix patients. Every patient had six plans named SL1, SL5, SL10, SL15, SL20, and NSL. In each case, the value of the shaping loop will be changed during the VMAT plan, while the other optimization parameters and constraint functions will remain the same in each case. All Dosimetric parameters have been measured and analysed for Planning Target Volume (PTV) and Organ at risk (OAR) dose, Monitor Unit (MU), memory, Plan Delivery Time (PDT), and Gamma Passing Rate (GPR) for comparison purposes.
Results: In NSL cases, the PTV dose derived from the DVH did not meet the clinical standards D95% = 86.8% (<95%) with a poorer homogeneity index (HI = 0.2). As the SL value increases, plan quality increases, monitor units increase slightly and plan delivery time decreases while there is a parallel increase in memory consumption. There is no statistical difference in target dose and OAR dose between the SL5 and SL1 plans (P > 0.05) compared with the other groups. SL5 has the least plan memory compared to other SL values.
Conclusion: Based on the plan quality, the dose accuracy, and the efficiency of delivery, SL1 and SL5 have similar characteristics in cervical cancer cases. Both SL1 and SL5 values should recommend for cervical cancer VMAT planning.
Keywords
Cervical Cancer
VMAT
Sequencing Parameter
Volumetric Modulated Arc Therapy
Subjects
  1. Zhang S, Xu H, Zhang L, Qiao Y. Cervical cancer: Epidemiology, risk factors and screening. Chin J Cancer Res. 2020;32(6):720-8.
  2. Burmeister CA, Khan SF, Schäfer G, et al. Cervical cancer therapies: Current challenges and future perspectives. Tumour Virus Res. 2022;13:200238.
  3. Singh GK, Azuine RE, Siahpush M. Global inequalities in cervical cancer incidence and mortality are linked to deprivation, low socioeconomic status, and human development. International Journal of MCH and AIDS. 2012;1(1):17.
  4. Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. The lancet global health. 2023 Feb 1;11(2):e197-206.
  5. Matuszak MM, Yan D, Grills I, Martinez A. Clinical applications of volumetric modulated arc therapy. Int J Radiat Oncol Biol Phys. 2010;77(2):608-16.
  6. McGrath SD, Matuszak MM, Yan D, Kestin LL, Martinez AA, Grills IS. Volumetric modulated arc therapy for delivery of hypofractionated stereotactic lung radiotherapy: A dosimetric and treatment efficiency analysis. Radiother Oncol. 2010;95(2):153-7.
  7. Diot Q, Kavanagh B, Timmerman R, Miften M. Biological-based optimization and volumetric modulated arc therapy delivery for stereotactic body radiation therapy. Med Phys. 2012;39(1):237-45.
  8. Chow JC, Wong E, Chen JZ, Van Dyk J. Comparison of dose calculation algorithms with Monte Carlo methods for photon arcs. Med Phys. 2003;30(10):2686-94.
  9. Ma CM, Mok E, Kapur A, et al. Clinical implementation of a Monte Carlo treatment planning system. Med Phys. 1999;26(10):2133-43.
  10. Abbas AS, Moseley D, Kassam Z, Kim SM, Cho C. Volumetric‐modulated arc therapy for the treatment of a large planning target volume in thoracic esophageal cancer. Journal of Applied Clinical Medical Physics. 2013 May;14(3):192-202.
  11. Chen A, Li Z, Chen L, Lin M, Li B, Chen F. The influence of increment of gantry on VMAT plan quality for cervical cancer. Journal of Radiation Research and Applied Sciences. 2019 Jan 1;12(1):447-54.
  12. Nithya L, Nambi Raj NA, Rathinamuthu S, Sharma K, Pandey MB. Influence of increment of gantry angle and number of arcs on esophageal volumetric modulated arc therapy planning in Monaco planning system: A planning study. J Med Phys. 2014;39:231.
  13. Clements M, Schupp N, Tattersall M, Brown A, Larson R. Monaco treatment planning system tools and optimization processes. Medical Dosimetry. 2018 Jun 1;43(2):106-17.
  14. Xiaolong HU, Jianhe YU, Lu WA, Li CH, Yanshu MU, Qun RE, et al. The Influence of SSO on the Optimization Result of Nasopharynx Carcinoma Plan. 2021.
  15. Shen J, Wang Y, Wang L, Gu P, Wang Z. Dosimetric effects of the custom dose iteration times on stereotactic radiotherapy for lung cancer. Radiation Physics and Chemistry, vol. 208, 2023.
  16. Wang Y, Chen L, Zhu F, Guo W, Zhang D, Sun W. A study of minimum segment width parameter on VMAT plan quality, delivery accuracy, and efficiency for cervical cancer using Monaco TPS. Journal of Applied Clinical Medical Physics. 2018 Sep;19(5):609-15.
  17. Huang L, Zhuang T, Mastroianni A, Djemil T, Cui T, Xia P. Impact of small MU/segment and dose rate on delivery accuracy of volumetric‐modulated arc therapy (VMAT). Journal of applied clinical medical physics. 2016 May;17(3):203-10.
  18. Yang K, Yan D, Tyagi N. Sensitivity analysis of physics and planning SmartArc parameters for single and partial arc VMAT planning. Journal of Applied Clinical Medical Physics. 2012 Nov;13(6):34-45.
  19. Moon YM, Bae SI, Choi CW, Jeon WW, Kim JY, Lee MW, et al. Effect of minimum segment width on gamma passing rate considering MLC position error for volumetric modulated arc therapy. Journal of the Korean Physical Society. 2019 Apr;74:724-30.
  20. Yoosuf AM, Ahmad MB, AlShehri S, Alhadab A, Alqathami M. Investigation of optimum minimum segment width on VMAT plan quality and deliverability: A comprehensive dosimetric and clinical evaluation using DVH analysis. Journal of Applied Clinical Medical Physics. 2021 Nov;22(11):29-40.
  21. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021 May;71(3):209-49.
  22. Yang J, Cai H, Xiao ZX, Wang H, Yang P. Effect of radiotherapy on the survival of cervical cancer patients: An analysis based on SEER database. Medicine (Baltimore). 2019;98(30):e16421.
  23. Chino J, Annunziata CM, Beriwal S, et al. Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline. Pract Radiat Oncol. 2020;10(4):220-34.
  24. Faye MD, Alfieri J. Advances in Radiation Oncology for the Treatment of Cervical Cancer. Current Oncology. 2022; 29(2):928-44.
  25. Ezzell GA, Burmeister JW, Dogan N, et al. IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. Med Phys. 2009;36(11):5359-73.
Iranian Journal of Medical Physics
Volume 21, Issue 4 - Serial Number 4
July and August 2024
Pages 258-264

  • Receive Date 29 November 2022
  • Revise Date 17 July 2024
  • Accept Date 16 May 2023