Abstract
Applying dual, or mixed photon energies during radiation therapy is a common practice
in 3-dimensional conformal radiation therapy (3D-CRT). Mixed photon energies are used
to provide uniform dose coverage to a planning target volume (PTV) that ranges in
depth from the skin surface. Though the application of mixed photon energies in 3D-CRT
was once the convention for treating anal cancers with lymph node involvement (AC-LNI),
the advantages offered by volumetric modulated arc therapy (VMAT) prove to be the
optimal form of therapy for AC-LNI. Recently, multiple researchers have uncovered
benefits in employing multiple photon energies in VMAT planning for prostate cancer.
A retrospective study was completed to assess the impact of implementing mixed energy
VMAT planning in comparison to conventional single energy VMAT planning for AC-LNI.
Data from 20 patients with AC-LNI was collected to analyze the dosimetric effects
of mixed energy VMAT treatments in terms of PTV conformity index, PTV homogeneity
index, monitor unit usage, and organs at risk sparing. For each patient 3 treatment
plans were created: a single energy 6 MV plan, a single energy 10 MV plan, and a mixed
6 MV and 10 MV energy plan. Analysis of the resulting dosimetric outcomes showed statistical
significance. The current study concluded that mixed energy VMAT plans have some effect
on treating AC-LNI when compared to single energy VMAT plans.
Keywords
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Article info
Publication history
Published online: June 07, 2020
Accepted:
April 15,
2020
Received in revised form:
March 25,
2020
Received:
December 11,
2019
Identification
Copyright
© 2020 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.