Dynamic conformal arc therapy, coplanar and non-coplanar volumetric modulated arc therapy, in brain tumor ballistics: A dosimetric comparison experience of Casablanca Cancer Center

Abstract

Author(s): Ardouz Anas*, El Baydaoui Redouane, Khobbaizi Youness, Nabil Sanaa, Mkimel Mounir, Abarane Abdelouahab, Bougteb Mustapha and Mesradi Mohammed Reda

The Novalis Tx Linear Accelerator is among the machines dedicated to radiosurgery that allow stereotactic radiotherapy based on Dynamic Conformal Arc Therapy (DCAT) or Volumetric Modulated Arc Treatment (VMAT), which are the conventional methods for treating brain metastases. Nevertheless, VMAT may reduce early or late complication probability by providing highly conformal dose distributions, increasing target volume coverage, and sparing normal tissues. A further enhancement of the conformation and dose gradient may be one of the possible benefits of the addition of non-coplanar arcs. The purpose of this article is to compare and analyse VMAT, DCAT, and VMAT with Non-Coplanar Arcs (NcVMAT). DCAT, CoVMAT, and NcVMAT modalities were created for 15 patients. Target conformal dose, target coverage, and normal brain tissue dose were evaluated among the three modalities. The NcVMAT modality greatly outperformed the others in terms of both conformal indices (RTOG-CI and IP-CI) and the dose gradient index. Dose comparisons to normal brain tissue revealed that the doses received by the healthy brain were significantly lower in the NcVMAT plans. The MUs of the DCAT and NcVMAT plans were larger than those of the CoVMAT plans. The NcVMAT modality dramatically increases the target conformal dose and gives a lower dose to normal brain tissue compared to the CoVMAT and DCAT modalities.

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