Fifty-seventh annual meeting of the American association of physicists in medicine
SU-E-T-262: Development of An In-House Forward Planning System for Conformal Arc Therapy
Conformal radiotherapy with forward planning has many practical advantages (e.g., more uniform target dose) and has been used routinely for stereotactic body radiation therapy (SBRT) and other conventional treatment. This study investigates a forward-planning approach for conformal arc therapy and a dedicated treatment planning system (TPS) for a newly designed cobalt 60 machine with a ring type gantry and a multileaf collimator (MLC).
Conformal arcs were modeled with continuous delivery of treatment fields conformal to the target cross-section. Treatment plans were further optimized by weighting or offsetting beams based on the target-critical structure relationship. CT and structure data of seven previous SBRT patients treated at our center were used for plan evaluation. An in-house forward planning tool was developed to aid the forward planning process. A graphical user interface (GUI) was designed with interactive and automatic adjustment between beam gantry angle and the beam weight. Dose distributions were calculated using our in-house Monte Carlo based TPS. Dose contributions from individual beam angles were summed together with different weight factors, which were continuously optimized until the pre-set dose conformity goal was met.
We were able to achieve target coverage and critical structure sparing to meet the required clinical criteria in all studied cases. It should be mentioned that those cases were selected having critical structures not proximal to the target. However, this was usually the case in the majority of SBRT cases especially those involving lung targets. The developed GUI tool was very useful in the forward treatment planning process.
Conformal arcs can be used successfully on the new Cobalt 60 modality for the treatment of a sizeable fraction of cancer patients, which can be efficiently planned with our simple forward planning approach.