JOURNAL OF MEDICAL PHYSICS, vol.41, no.2, pp.100-105, 2016 (ESCI)
To investigate the dose-volume variations of planning target volume (PTV) and organ at risks (OARs) in eleven prostate cancer patients planned with single and double arc volumetric modulated arc therapy (VMAT) when varying collimator angle. Single and double arc VMAT treatment plans were created using Monaco5.0 (R) with collimator angle set to 0 degrees. All plans were normalized 7600 cGy dose to the 95% of clinical target volume (CTV) volume. The single arc VMAT plans were reoptimized with different collimator angles (0 degrees, 15 degrees, 30 degrees, 45 degrees, 60 degrees, 75 degrees, and 90 degrees), and for double arc VMAT plans (0-0 degrees, 15 degrees-345, 30-330 degrees, 45-315 degrees, 60-300 degrees, 75-285 degrees, 90-270 degrees) using the same optimization parameters. For the comparison the parameters of heterogeneity index (HI), dose-volume histogram and minimum dose to the 95% of PTV volume (D95 PTV) calculated and analyzed. The best plans were verified using 2 dimensional ion chamber array IBA Matrixx (R) and three-dimensional IBA Compass (R) program. The comparison between calculation and measurement were made by the gamma-index (3%/3 mm) analysis. A higher D95 (PTV) were found for single arc VMAT with 15 degrees collimator angle. For double arc, VMAT with 60-300 degrees and 75-285 degrees collimator angles. However, lower rectum doses obtained for 75-285 degrees collimator angles. There was no significant dose difference, based on other OARs which are bladder and femur head. When we compared single and double arc VMAT's D95 (PTV), we determined 2.44% high coverage and lower HI with double arc VMAT. All plans passed the gamma-index (3%/3 mm) analysis with more than 97% of the points and we had an average gamma-index for CTV 0.36, for PTV 0.32 with double arc VMAT. These results were significant by Wilcoxon signed rank test statistically. The results show that dose coverage of target and OAR's doses also depend significantly on the collimator angles due to the geometry of target and OARs. Based on the results we have decided to plan prostate cancer patients in our clinic with double arc VMAT and 75 degrees-285 degrees collimator angles.