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- W2116035694 abstract "Malignant pleural mesothelioma (MPM) is an aggressive tumor with disastrous prognosis. Many RT procedures, were evaluated to cover the large and irregular target and to limit the dose at the nearness risk structures. In this work the feasibility of volumetric modulated arcs therapy with RapidArc (RA) technique for adjuvant radiotherapy treatment of MPM was evaluated in comparison with fixed field IMRT. A retrospective analysis was performed on 6 patients affected by MPM and enrolled for adjuvant RT (3 left/right sides). The CTV was defined as the region of resection and other areas considered at high risk. The PTV was delineated by uniform margins of 5 mm around CTV. The plans were normalized at PTV mean dose, dose prescription was 54 Gy, with 2 Gy/fraction. For RapidArc two coplanar full arcs using 18 MV were used, whereas 9 fields with mix 6 and 18 MV energies were applied to IMRT plans. Planning objectives were: PTV: V95%>95%, controlateral lung: V5Gy<60%, V20Gy<10%, mean dose<9.5Gy, Liver: V30Gy<33%, mean dose<31Gy; Heart: V45Gy<30%, V50Gy<20%, DMax<60Gy; Spinal cord: V45Gy<1%, DMax<50Gy, Contralateral kidney: V15Gy<20%, Esophagus: V55Gy<30%, Spleen: V40Gy<50%. The plans were compared by analyzing target coverage, homogeneity and normal tissue sparing. Both IMRT and RA met the target objective on CTV (V95%=95.3±8.5 for IMRT and 98.7±1.4 for RA) and approached it on PTV (V95%=93.3±7.7 and 93.5±3.4). Target homogeneity resulted equivalent between RA (D5%-D95%=5.9±0.8) and IMRT (D5%-D95%=6.0±1.5). All the objectives for OARs were met for both techniques: contralateral mean lung doses were 5.8±0.8 and 5.6±0.7 Gy respectively for IMRT and RA, with V5Gy=45.0±12.6% and V20Gy=2.0±0.9% for IMRT, V5Gy =47.9±7.4% and V20Gy=0.4±0.4% for (RA). Heart resulted with IMRT V45Gy=15.6±4.0% and V50Gy=6.1±1.5%, while with RA V45Gy=19.2±11.5% and V50Gy=12.0±7.2%. Liver V30Gy was 15.1±12.8% and 12.8±14.0% with IMRT and RA, respectively. Spleen had V40Gy=39.4±6.3% with IMRT and 40.5±7.4% with RA. Esophagus V55Gy was 8.2±14.4% and 4.4±9.2% with IMRT and RA. V15Gy to contralateral kidney, as well as V45Gy to spine presented 0% volume for both techniques. For healthy tissue, integral dose resulted equivalent between the two techniques. Concerning delivery parameters, RapidArc resulted in reducing total monitor units 2195±317 for IMRT and 734±82 for RA. The dosimetric findings are significantly favorable for RapidArc and, from the clinical perspective, these data could increase the population candidate to RT of MPM after radical surgery. An upcoming Phase I trial on patients will start to evaluate the clinical outcomes with RapidArc." @default.
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- W2116035694 date "2009-11-01" @default.
- W2116035694 modified "2023-09-27" @default.
- W2116035694 title "Feasibility Study of Volumetric Modulated Arc Therapy for Malignant Pleural Mesothelioma Tumor" @default.
- W2116035694 doi "https://doi.org/10.1016/j.ijrobp.2009.07.1629" @default.
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