Evaluation of the clinical usefulness of modulated Arc treatment

TL;DR

This study evaluates the clinical usefulness of modulated Arc (mARC) treatment for non-small cell lung cancer, comparing its dosimetric performance and efficiency against Tomotherapy and RapidArc, and finds mARC to be a promising technique.

Contribution

The paper identifies optimal mARC treatment parameters and demonstrates its comparable target coverage with reduced treatment time and dose to normal tissues.

Findings

mARC has optimal performance at 10 MV photon energy and 6° point angle with 59 segments

mARC reduces monitor units and beam on time compared to other techniques

mARC provides similar target coverage with lower normal tissue dose

Abstract

The purpose of this study is to evaluate the clinical usefulness of modulated arc (mARC) treatment techniques. The mARC treatment plans of the non-small cell lung cancer (NSCLC) patients were performed in order to verify the clinical usefulness of mARC. A pre study was conducted to find the most competent plan condition of mARC treatment and the usefulness of mARC treatment plan was evaluated by comparing it with the other Arc treatment plans such as Tomotherapy and RapidArc. In the case of mARC, the optimal condition for the mARC plan was determined by comparing the dosimetric performance of the mARC plans with the use of various parameters. The various parameters includes the photon energies (6 MV, 10 MV), optimization point angle (6{\deg}-10{\deg} intervals), and total segment number (36-59 segment). The best dosimetric performance of mARC was observed at 10 MV photon energy and the point angle 6 degree, and 59 segments. The each treatment plans of three different techniques were compared with the following parameters: conformity index (CI), homogeneity index (HI), target coverage, dose in the OARs, monitor units (MU), beam on time and the normal tissue complication probability (NTCP). As a result, all three different treatment techniques show the similar target coverage. The mARC results the lowest V20 and MU per fraction compared with both RapidArc and Tomotherapy plan. The mARC plan reduces the beam on time as well. Therefore, the results of this study provided a satisfactory result which mARC technique is considered as a useful clinical technique for radiation treatment.