Sang Won Kang, Jin Beom Chung, Jae Sung Kim, In Ah Kim, Keun Yong Eom, Changhoon Song, Jeong Woo Lee, Jin Young Kim and Tae Suk Suh
Prostate cancer is the most common cancer in men, accounting for over one fifth of male cancer diagnoses, with the number of prostate cancer patients rapidly increasing. Various radiotherapy techniques for treating prostate cancer have been considered effective noninvasive treatment options, especially for elderly patients and those unfit for surgery. 1 - 3
Radiation therapy options for prostate cancer include external beam radiation therapy (EBRT) and brachytherapy. Volumetricmodulatedarctherapy (VMAT) and intensity-modulated radiation
of these studies show no clear benefit to using higher energy photons.
VolumetricModulatedArcTherapy (VMAT) has now begun to replace IMRT for treating prostate cancer, and numerous studies show that using VMAT instead of IMRT for prostate cancer results in dosimetric benefits, such as reduced treatment time and more dose sparing to OAR. 15 - 20 Therefore, it is relevant to investigate if using higher energy photons has greater potency than using the traditional 6 MV for VMAT. To deal with the issue of neutron contamination, 10 MV photons were used for this
Hironori Akiyama, Csilla Pesznyák, Dalma Béla, Örs Ferenczi, Tibor Major, Csaba Polgár and Zoltán Takácsi-Nagy
achieved higher dose conformity with better organs at risk (OARs) sparing compared to 3-dimensional conformal radiation therapy. 8 Volumetricmodulatedarctherapy (VMAT), an improved technique of IMRT offers reduced irradiation time compared to IMRT. 9 Nowadays IGBT meets the challenge of high precision EBRT such as VMAT, which is a non-invasive modality and does not require special skills to deliver a high conformal dose to the target volume while saving critical normal structures. To our knowledge no detailed dosimetric comparisons of IGBT with VMAT have so far been
intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys., 2000;48(2):329–337.
7. Otto K. - Volumetricmodulatedarctherapy: IMRT in a single gantry arc. Med Phys., 2008;35(1):310-317.
8. Zhao N., Yang R., Jiang Y., Tian S., Guo F., Wang J. - A Hybrid IMRT/VMAT Technique for the Treatment of Nasopharyngeal Cancer. BioMed Research International, 2015;(2015). Article ID 940102.
9. Verbakel W.F., Cuijpers J.P., Hoffmans D., Bieker M., Slotman B.J., Senan S. - Volumetric intensity-modulatedarctherapy vs. conventional
Christopher Amaloo, Daryl P. Nazareth and Lalith K. Kumaraswamy
in 772 patients. Int J Radiat Oncol 2002; 53: 1111-6.
9. Zelefsky MJ, Chan H, Hunt M, Yamada Y, Shippy AM, Amols H. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urology 2006; 176: 1415-9.
10. Cozzi L, Dinshaw KA, Shrivastava SK, Mahantshetty U, Engineer R, Deshpande DD, et al. A treatment planning study comparing volumetricarc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy. Radiother Oncol 2008; 89: 180-91.
11. Wolff D
Petch Alisanant, Tassapong Raiyawa, Sivalee Suriyapee and Sornjarod Oonsiri
, Sanghangthum T, Israngkul Na Ayuthaya I, Shotelersuk K. Dosimetry of conformal dynamic arc radiotherapy and intensity modulated radiotherapy in unresectable cholangiocarcinoma. Asian Biomed. 2010; 4;131-9.
5. Verbakel WF, Cuijpers JP, Hoffmans D, Bieker M, Slotman BJ, Senan S. Volumetric intensity-modulatedarctherapy vs. conventional IMRT in head-and-neck cancer: a comparative planning and dosimetric study. Int J Radiat Oncol Biol Phys. 2009; 74:252-9.
6. Popescu CC, Olivotto IA, Beckham WA, Ansbacher W, Zavgorodni S, Shaffer R, et al
Zhengzheng Xu, Iris Z. Wang, Lalith K. Kumaraswamy and Matthew B. Podgorsak
Volumetricmodulatedarctherapy (VMAT) demands high level of precision and reliability from the linear accelerator (LINAC) control system because the gantry rotation is synchronized with multi-leaf collimator (MLC) movement for accurate dose delivery. 1 , 2 Highly modulated dose distribution commonly requires MLC leaves of high speed moving along the whole arc. 3 – 5 However, fast leaf motion during gantry rotation may be affected by interleaf friction or MLC motor problems that result in leaf position errors. 6 Wijesooriya et al and Ling
Qian Zhang, Xiao Li Yu, Wei Gang Hu, Jia Yi Chen, Jia Zhou Wang, Jin Song Ye and Xiao Mao Guo
irradiation. Radiother Oncol 2010; 94: 235-40.
15. Zhang Q, Chen JY, Hu WG, Guo XM. Modified partially wide tangents technique in post-mastectomy radiotherapy for patients with left-sided breast cancer. Chin Med J (Engl) 2010; 123: 2825-31.
16. Palma D, Vollans E, James K, Nakano S, Moiseenko V, Shaffer R, et al. Volumetricmodulatedarctherapy for delivery of prostate radiotherapy: comparison with intensity-modulated radiotherapy and three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 2008; 72: 996
Agata Jodda, Bartosz Urbański, Tomasz Piotrowski and Julian Malicki
the adjuvant treatment of gynecologic malignancies: a comparative dosimetric study of dose-volume histograms. Gynecol Oncol. 2003;91(1):39-45.
 Cozzi L, Dinshaw KA, Shrivastava SK, et al. Treatment planning study comparing volumetricarc modulation with RapidArc and fixed field IMRT for cervix uteri radiotherapy. Radiother Oncol. 2008;89(2):180-191.
 Brixey CJ, Roeske JC, Lujan AE, et al. Impact of intensity modulated radiation therapy on acute hematologic toxicity in women with gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2002; 54
Manthala Padannayil Noufal, Kallikuzhiyil Kochunny Abdullah, Puzhakkal Niyas and Pallimanhayil Abdul Raheem Subha
 Verbakel WF, Cuijpers J P, Hoffmans D, et al. Volumetric intensity-modulatedarctherapy versus conventional IMRT in head-and-neck cancer: a comparative planning and dosimetric study. Int J Radiat Oncol Biol Phys. 2009;74(1):252–259.
 Wolff D, Stieler F, Welzel G, et al. Volumetricmodulatedarctherapy (VMAT) versus serial tomotherapy, step-and-shoot IMRT and 3D-conformal RT for treatment of prostate cancer. Radiother Oncol. 2009;93(2):226–233.
 Otto K. Volumetricmodulatedarctherapy: IMRT in a single gantry arc. Med Phys