A column generation heuristic for VMAT planning with adaptive CVaR constraints.

In this study we develop an efficient computational procedure that generates medically acceptable treatment plans for volumetric modulated arc therapy with constant gantry speed. Our proposed method is a column generation heuristic based on a mixed integer linear programming model, where the objective function contains minimization of total monitor unit of the treatment plan and dose-volume requirements are included as conditional value-at-risk constraints. Our heuristic generates a full treatment arc for the restricted master problem and calibrates the right hand side parameters of the conditional value-at-risk constraints in the first phase. In the second phase, this initial solution is improved by performing column generation. This is a fully automated procedure and produces treatment plans in a single call without any human intervention. We evaluate its performance on real prostate cancer data by comparing the quality of the generated plans with those obtained by a widely used commercial treatment planning system. Our analysis shows that the results are promising, and the generated plans satisfy the prescription restrictions and require [Formula: see text] fewer monitor units on average compared to the ones obtained using Eclipse.

Investigation of AAA dose calculation algorithm accuracy in surface and buildup region for 6MV photon beam using markus parallel-plate ion chamber.

In radiotherapy, dose distributions are obtained by using dose calculation algorithms that are implanted in treatment planning systems (TPS). This study aims to compare the surface doses of separate field sizes calculated by different version of The Analytical Anisotropic Algorithm (AAA) and measured by the parallel-plate ion chamber that is admitted as the most reliable dosimetry system for the surface region dose measurements. In order to measure the near surface dose, water equivalent solid phantom was used and measurements were made for 6MV photon beam at 100 cm source-detector distance for 5×5, 10×10, and 20×20 cm2 field sizes. AAA 8.9 and AAA 15.1 versions of the Varian Eclipse TPS were used for surface dose calculations by generating beams with separate field sizes. The doses were read by considering the effective buildup thickness of Markus parallel-plate ion chamber. The surface doses using 6 MV photon beams for 10×10 cm2 field size at 0.07 mm were found to be 11.04%, 26.25%, and 19.69% for AAA v8.9, AAA v15.1 and Markus chamber, respectively. It was seen that for both of the AAA versions and Markus parallel-plate ion chamber, increasing field sizes also increase surface dose. For all field sizes, surface dose was lowest by using AAA v8.9 at 0.07 mm. The different versions of the same TPS algorithms may calculate the surface doses distinctively. After upgrading of TPS algorithms, surface doses should be calculated and compared by measurements with different dosimetry systems to better understand their calculation behaviors in the near surface region.

Nasopharyngeal carcinoma radiotherapy with hybrid technique.

The aim of the study was to investigate the effect of the Hybrid technique which was created by combining of intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) for the treatment of nasopharyngeal cancer (NPC) patients. 7 to 9 field IMRT, triple arc VMAT, and Hybrid plans were generated for 10 advanced stage NPC patients. The homogeneity index (HI) and the conformity index (CI) of planning target volumes (PTVs) were calculated for each technique to evaluate the plan quality. The techniques were compared in terms of plan quality, sparing of organs at risk (OARs), monitor units (MUs), and delivery time. Hybrid technique significantly improved the target dose homogeneity and the conformity for PTV70 and PTV60 compared to IMRT and VMAT. Hybrid plans significantly reduced the maximum dose of the brainstem sparing compared to the VMAT plans and also improved the sparing of spinal cord compared to IMRT and VMAT. The MUs and the delivery time of Hybrid plans were found to be between values for IMRT and VMAT plans. Hybrid technique can be useful when IMRT and VMAT techniques are not adequate alone in the treatment of NPC patients.