Orlandini Lucia Clara, Betti Margherita, Fulcheri Christian, Coppola Marianna, Cionini Luca
Medical Physics Unit, Centro Oncologico Fiorentino, Via A. Ragionieri 101, 50019 Sesto Fiorentino, Italy.
Radiation Oncology Department, Centro Oncologico Fiorentino, Via A. Ragionieri 101, 50019 Sesto Fiorentino, Italy.
Rep Pract Oncol Radiother. 2015 Sep-Oct;20(5):358-64. doi: 10.1016/j.rpor.2015.06.005. Epub 2015 Sep 29.
The main purpose of this study is to perform a dosimetric comparison on target volumes and organs at risks (OARs) between prostate intensity modulated treatment plans (IMRT) optimized with different multileaf collimators (MLCs).
The use of MLCs with a small leaf width in the IMRT optimization may improve conformity around the tumor target whilst reducing the dose to normal tissues.
Two linacs mounting MLCs with 5 and 10 mm leaf-width, respectively, implemented in Pinnacle(3) treatment planning system were used for this work. Nineteen patients with prostate carcinoma undergoing a radiotherapy treatment were enrolled. Treatment planning with different setup arrangements (7 and 5 beams) were performed for each patient and each machine. Dose volume histograms (DVHs) cut-off points were used in the treatment planning comparison.
Comparable planning target volume (PTV) coverage was obtained with 7- and 5-beam configuration (both with 5 and 10 mm MLC leaf-width). The comparison of bladder and rectum DVH cut-off points for the 5-beam arrangement shows that 52.6% of the plans optimized with a larger leaf-width did not satisfy at least one of the OARs' constraints. This percentage is reduced to 10.5% for the smaller leaf-width. If a 7-beam arrangement is used the value of 52.6% decreases to 21.1% while the value of 10.5% remains unchanged.
MLCs collimators with different widths and number of leaves lead to a comparable prostate treatment planning if a proper adjustment is made of the number of gantry angles.