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Helical tomotherapy and two types of volumetric modulated arc therapy: dosimetric and clinical comparison for several cancer sites

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Abstract

Radiotherapy accelerators have undergone continuous technological developments. We investigated the differences between Radixact™ and VMAT treatment plans. Sixty patients were included in this study. Dosimetric comparison between the Radixact™ and VMAT plans was performed for six cancer sites: whole-brain, head and neck, lymphoma, lung, prostate, and rectum. The VMAT plans were generated with two Elekta linear accelerators (Synergy® and Versa HD™). The planning target volume (PTV) coverage, organs-at-risk dose constraints, and four dosimetric indexes were considered. The deliverability of the plans was assessed using quality assurance (gamma index evaluation) measurements; clinical judgment was included in the assessment. The mean AAPM TG218 (3%–2 mm, global normalization) gamma index values were 99.4%, 97.8%, and 96.6% for Radixact™, Versa HD™, and Synergy®, respectively. Radixact™ performed better than Versa HD™ in terms of dosimetric indexes, hippocampi D100%, spinal cord Dmax, rectum V38.4  Gy, bladder V30 Gy, and V40 Gy. Versa HD™ saved more of the (lungs-PTV) V5 Gy and (lungs-PTV) Dmean, heart Dmean, breasts V4 Gy, and bowel V45 Gy. Regarding Synergy®, the head and neck Radixact™ plan saved more of the parotid gland, oral cavity, and supraglottic larynx. From a clinical point of view, for the head and neck, prostate, and rectal sites, the Radixact™ and Versa HD™ plans were similar; Radixact™ plans were preferable for the head and neck and rectum to Synergy® plans. The quality of linac plans has improved, and differences with tomotherapy have decreased. However, tomotherapy continues to be an essential add-on in multi-machine departments.

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Funding

No funds, grants, or other support was received for conducting this study. The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Medical Physics Unit, A.O.U. Città della Salute e della Scienza, Corso Bramante 88/90, 10126, Turin, TO, Italy

    Elena Gallio, Anna Sardo, Veronica Richetto & Francesca Romana Giglioli

  2. Department of Oncology, University of Turin, Via Santena 5 Bis, 10126, Turin, TO, Italy

    Serena Badellino, Cristina Mantovani, Mario Levis, Christian Fiandra, Alessia Guarneri, Francesca Arcadipane & Umberto Ricardi

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  1. Elena Gallio
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  2. Anna Sardo
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  3. Serena Badellino
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  4. Cristina Mantovani
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  5. Mario Levis
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Correspondence to Elena Gallio.

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The authors declare that they have all participated in the design, execution, and analysis of the paper and that they have approved the final version. Also, they declare that they have no conflict of interest in connection with the paper and that material described is not under publication or consideration for publication elsewhere.

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Gallio, E., Sardo, A., Badellino, S. et al. Helical tomotherapy and two types of volumetric modulated arc therapy: dosimetric and clinical comparison for several cancer sites. Radiol Phys Technol 16, 272–283 (2023). https://doi.org/10.1007/s12194-023-00716-3

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  • DOI: https://doi.org/10.1007/s12194-023-00716-3

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