Dosimetric Evaluation of Treatment Plans for a Biology-Guided Radiation Therapy System in Treatment of Nasopharyngeal Cancer
Abstract
Purpose/Objective(s): This is an evaluation of a prototype treatment planning system (TPS) for a new biology-guided radiotherapy (BgRT) delivery system currently under development. The system combines a compact 6 MV linear accelerator and binary multileaf collimator with PET, kVCT, and MV imaging systems on the same ring gantry that rotates continuously at 60 rotations per minute while the patient is translated through the bore. We investigated the plan quality for treatment of nasopharyngeal patients without using PET guidance by comparing the plans with those using existing IMRT delivery techniques. Materials/Methods: We retrospectively retrieved 5 clinical helical tomotherapy (HT) plans using a 2.5 cm jaw size and 3 clinical step-and-shoot IMRT plans with seven co-planar 6-MV fields that were used to treat nasopharyngeal patients according to the NRG-HN001 protocol, each with 3 or 4 PTVs at different prescription dose levels given in 33 equal fractions. A treatment plan (the prototype plan) using the prototype TPS was generated for each case, which models a binary delivery system that fires at 51 fixed gantry angles with each leaf fully opened or closed. Dose modulation is achieved with fast gantry rotation, couch moving in small increments, and each firing position being visited multiple times in the same axial plane. Volumetric modulated arc therapy (VMAT) plans using two coplanar 6 MV full arc fields were also generated for all 8 cases, where maximum sparing of organs…
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