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dc.contributor.authorEdmunds, K
dc.contributor.authorBedford, J
dc.date.accessioned2018-07-23T15:05:55Z
dc.date.issued2013-03
dc.identifier1023
dc.identifier.citationBRITISH JOURNAL OF RADIOLOGY, 2013, 86
dc.identifier.issn0007-1285
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/2120
dc.identifier.doi10.1259/bjr.20120498
dc.description.abstractVolumetric-modulated arc therapy (VMAT) is increasingly popular as a treatment method in radiotherapy owing to the speed with which treatments can be delivered. However, there has been little investigation into the effect of increased modulation in lung plans with regard to interfraction organ motion. This is most likely to occur where the planning target volume (PTV) lies within areas of low density. This paper aims to investigate the effect of modulation on the dose distribution using simulated patient movement and to propose a method that is less susceptible to such movement. Simulated interfraction motion is achieved by moving the plan isocentre in steps of 0.5 cm and 1.0 cm in six directions for five clinical VMAT patients. The proposed planning method involves optimisation using a density override of 1 g cm(-3), within the PTV in lung, to reduce segment boosting in the periphery of the PTV. This investigation shows that modulation can result in an increase in the maximum dose of >25%, an increase in PTV near-maximum dose of 17% and a reduction in near-minimum dose by 46%. Unacceptable organ at risk (OAR) doses are also seen. The proposed method reduces modulation, resulting in a maximum dose increase of 10%. Although safeguards are in place to prevent the increased dose to OARs from patient movement, there is nothing to prevent the increased dose as a result of modulation in lung. A simple planning method is proposed to safeguard against this effect. Investigation suggests that, where modulation exists in a plan, this method reduces it and is clinically viable.
dc.languageeng
dc.language.isoeng
dc.publisherBRITISH INST RADIOLOGY
dc.titleAssessment of the robustness of volumetric-modulated arc therapy for lung radiotherapy
dc.typeJournal Article
rioxxterms.versionofrecord10.1259/bjr.20120498
rioxxterms.licenseref.startdate2013-03
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBRITISH JOURNAL OF RADIOLOGY
pubs.notesaffiliation: Edmunds, K (Reprint Author), Royal Marsden NHS Fdn Trust, Sutton, Surrey, England. Edmunds, K.; Bedford, J., Royal Marsden NHS Fdn Trust, Sutton, Surrey, England. article-number: UNSP 20120498 research-areas: Radiology, Nuclear Medicine & Medical Imaging web-of-science-categories: Radiology, Nuclear Medicine & Medical Imaging author-email: [email protected] number-of-cited-references: 12 times-cited: 2 usage-count-last-180-days: 0 usage-count-since-2013: 1 journal-iso: Br. J. Radiol. doc-delivery-number: 094MP unique-id: ISI:000315268200004 oa: green_published da: 2018-07-23
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy treatment planning
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy treatment planning/Radiotherapy treatment planning (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy treatment planning
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy treatment planning/Radiotherapy treatment planning (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.volume86
pubs.embargo.termsNot known
icr.researchteamRadiotherapy treatment planningen_US
dc.contributor.icrauthorBedford, James Len


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