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Purpose <p>To identify dosimetric advantages of biaxially rotational dynamic radiation therapy (BROAD-RT) for stereotactic body radiation therapy (SBRT) with focal boost for non-metastatic prostate cancer (PCa), compared with coplanar volumetric-modulated arc therapy (co-VMAT).</p> Materials and methods <p>BROAD-RT is a unique beam delivery technique, which facilitates sequential non-coplanar beam delivery without the need to rotate the couch or reposition the patient. For 15 patients with non-metastatic PCa, two different plans (BROAD-RT and co-VMAT) were created, and these plans and dosimetric indices were compared. The prescribed dose was 35&#xa0;Gy in 5 fractions to the whole prostate gland, and that to the intra-prostatic dominant lesions (IPDLs) was increased up to 50&#xa0;Gy. Quality assurance (QA) was performed for BROAD-RT and co-VMAT plans from the 15 patients, and the calculated and measured dose distributions were evaluated according to global gamma analysis using ArcCHECK.</p> Results <p>The dose coverage of the target volumes and the high-dose exposure to organs at risk (rectum, bladder, and urethra) were not significantly different between BROAD-RT and co-VMAT plans. The normal tissue dose outside of the planning target volume (PTV) (maximum dose 2&#xa0;cm away from PTV [D2 cm], and 30%, 50%, or 70% isodose volume divided by the volume of PTV [R30, R50, and R70]) were significantly lower in the BROAD-RT plan (<i>p</i> &lt; 0.001, <i>p</i> &lt; 0.001, <i>p</i> &lt; 0.001, and <i>p</i> &lt; 0.001, respectively). In QA, average (± standard deviation) passing rates were 98.2 ± 0.7% for BROAD-RT and 99.0 ± 1.0% for co-VMAT.</p> Conclusion <p>Non-coplanar VMAT via BROAD-RT improved the dose distribution, mainly outside of the PTV and for some of the organs at risks, in prostate SBRT with focal boost compared with coplanar VMAT. Therefore, as BROAD-RT enables practical implementation of non-coplanar VMAT, it is considered a promising radiotherapy method of SBRT with focal boost for non-metastatic PCa.</p>

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Dosimetric advantages of non-coplanar volumetric modulated arc therapy (VMAT) using biaxially rotational dynamic radiation therapy compared with coplanar VMAT in prostate stereotactic body radiation therapy with focal boost

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  • 发表日期：

    2026年4月30日

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  • Rihito Aizawa,
  • Yuka Ono,
  • Hideaki Hirashima,
  • Takashi Ogata,
  • Shinya Hiraoka,
  • Mitsuhiro Nakamura,
  • Takashi Mizowaki

摘要

Purpose

To identify dosimetric advantages of biaxially rotational dynamic radiation therapy (BROAD-RT) for stereotactic body radiation therapy (SBRT) with focal boost for non-metastatic prostate cancer (PCa), compared with coplanar volumetric-modulated arc therapy (co-VMAT).

Materials and methods

BROAD-RT is a unique beam delivery technique, which facilitates sequential non-coplanar beam delivery without the need to rotate the couch or reposition the patient. For 15 patients with non-metastatic PCa, two different plans (BROAD-RT and co-VMAT) were created, and these plans and dosimetric indices were compared. The prescribed dose was 35 Gy in 5 fractions to the whole prostate gland, and that to the intra-prostatic dominant lesions (IPDLs) was increased up to 50 Gy. Quality assurance (QA) was performed for BROAD-RT and co-VMAT plans from the 15 patients, and the calculated and measured dose distributions were evaluated according to global gamma analysis using ArcCHECK.

Results

The dose coverage of the target volumes and the high-dose exposure to organs at risk (rectum, bladder, and urethra) were not significantly different between BROAD-RT and co-VMAT plans. The normal tissue dose outside of the planning target volume (PTV) (maximum dose 2 cm away from PTV [D2 cm], and 30%, 50%, or 70% isodose volume divided by the volume of PTV [R30, R50, and R70]) were significantly lower in the BROAD-RT plan (p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively). In QA, average (± standard deviation) passing rates were 98.2 ± 0.7% for BROAD-RT and 99.0 ± 1.0% for co-VMAT.

Conclusion

Non-coplanar VMAT via BROAD-RT improved the dose distribution, mainly outside of the PTV and for some of the organs at risks, in prostate SBRT with focal boost compared with coplanar VMAT. Therefore, as BROAD-RT enables practical implementation of non-coplanar VMAT, it is considered a promising radiotherapy method of SBRT with focal boost for non-metastatic PCa.