Delivery Parameter Variations and Early Clinical Outcomes of Volumetric Modulated Arc Therapy for 31 Prostate Cancer Patients: An Intercomparison of Three Treatment Planning Systems

Abstract EN

We created volumetric modulated arc therapy (VMAT) plans for 31 prostate cancer patients using one of three treatment planning systems (TPSs)—ERGO++, Monaco, or Pinnacle—and then treated those patients.

A dose of 74 Gy was prescribed to the planning target volume (PTV).

The rectum, bladder, and femur were chosen as organs at risk (OARs) with specified dose-volume constraints.

Dose volume histograms (DVHs), the mean dose rate, the beam-on time, and early treatment outcomes were evaluated and compared.

The DVHs calculated for the three TPSs were comparable.

The mean dose rates and beam-on times for Ergo++, Monaco, and SmartArc were, respectively, 174.3 ± 17.7, 149.7 ± 8.4, and 185.8 ± 15.6 MU/min and 132.7 ± 8.4, 217.6 ± 13.1, and 127.5 ± 27.1 sec.

During a follow-up period of 486.2 ± 289.9 days, local recurrence was not observed, but distant metastasis was observed in a single patient.

Adverse events of grade 3 to grade 4 were not observed.

The mean dose rate for Monaco was significantly lower than that for ERGO++ and SmartArc (P<0.0001), and the beam-on time for Monaco was significantly longer than that for ERGO++ and SmartArc (P<0.0001).

Each TPS was successfully used for prostate VMAT planning without significant differences in early clinical outcomes despite significant TPS-specific delivery parameter variations.