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Title: Dosimetric comparison between dual-isocentric dynamic conformal arc therapy and mono-isocentric volumetric-modulated arc therapy for two large brain metastases
Authors: Uto, Megumi  kyouindb  KAKEN_id
Mizowaki, Takashi  kyouindb  KAKEN_id  orcid (unconfirmed)
Ogura, Kengo
Mukumoto, Nobutaka  kyouindb  KAKEN_id
Katagiri, Tomohiro
Takehana, Keiichi
Hiraoka, Masahiro
Author's alias: 宇藤, 恵
溝脇, 尚志
小倉, 健吾
片桐, 幸大
平岡, 眞寛
Keywords: dynamic conformal arc therapy
volumetric-modulated arc therapy
two brain metastases
dosimetric comparison
Issue Date: Nov-2018
Publisher: Oxford University Press (OUP)
Journal title: Journal of radiation research
Volume: 59
Issue: 6
Start page: 774
End page: 781
Abstract: Mono-isocentric volumetric-modulated arc therapy (VMAT) can be used to treat multiple brain metastases. It remains unknown whether mono-isocentric VMAT can improve the dose distribution compared with dual-isocentric dynamic conformal arc therapy (DCAT), especially for two brain metastases. We compared the dose distribution between dual-isocentric DCAT and mono-isocentric VMAT for two large brain metastases, and analyzed the relationship between the distance between the two targets and the difference in dose distribution. A total of 19 patients, each with two large brain metastases, were enrolled. The dose prescribed for each planning target volume (PTV) was 28 Gy in five fractions (D99.8 = 100%). We created new indices derived from conformity indices suggested by the Radiation Therapy Oncology Group (RTOG; mRTOG-CI) and Paddick et al. (mIP-CI), using the dosimetric parameters of the sum of the two PTVs. The median PTV was 5.05 cm³ (range, 2.10–28.47). VMAT significantly improved mRTOG-CI and mIP-CI compared with DCAT. In all cases, VMAT was able to improve mRTOG-CI and mIP-CI compared with DCAT. Whereas the normal brain volume receiving 5 Gy was similar between the two modalities, the normal brain receiving 10, 12, 15, 20, 25 and 28 Gy (V₁₀-V₂₈) was significantly smaller in VMAT. The mean beam-on times were 213.3 s and 121.9 s in DCAT and VMAT, respectively (P < 0.001). Mono-isocentric VMAT improved the target conformity and reduced the beam-on time and V₁₀-V₂₈ of the normal brain for not only two close metastases but also two distant metastases. Mono-isocentric VMAT seems to be a promising treatment technique for two large brain metastases.
Rights: © The Author(s) 2018. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact
DOI(Published Version): 10.1093/jrr/rry064
PubMed ID: 30102325
Appears in Collections:Journal Articles

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