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Article

Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique

  • Authors:
    • Shuri Aoki
    • Hideomi Yamashita
    • Akihiro Haga
    • Kanabu Nawa
    • Toshikazu Imae
    • Wataru Takahashi
    • Osamu Abe
    • Keiichi Nakagawa
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, University of Tokyo Hospital, Tokyo 113‑8655, Japan
  • Pages: 3928-3936
    |
    Published online on: January 16, 2018
       https://doi.org/10.3892/ol.2018.7809
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Abstract

The present study sought to evaluate the impact of the flattening filter‑free (FFF) technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy. Its clinical safety and availability were compared with the flattening filter (FF) method. The cases of 65 patients who underwent lung volumetric modulated arc therapy‑stereotactic body radiotherapy (VMAT‑SBRT) using FF or FFF techniques were reviewed. A total of 55 Gy/4 fractions (fr) was prescribed for peripheral lesions or 56 Gy/7 fr for central lesions. The total monitor units (MU), treatment time, dose to tumors, dose to organs at risk, tumor control (local control rate, overall survival, progression‑free survival) and adverse events between cases treated with FF and cases treated with the FFF technique were compared. A total of 35 patients were treated with conventional FF techniques prior to November 2014 and 30 patients were treated with FFF techniques after this date. It was revealed that the beam‑on time was significantly shortened by the FFF technique (P<0.01). Other factors were similar for FFF and FF plans in respect to conformity (P=0.95), homogeneity (P=0.20) and other dosimetric values, including total MU and planning target volume/internal target volume coverage. The median follow‑up period was 18 months (range, 2‑35). One‑year local control rates were 97.1 and 90.0% in the FF group and FFF groups, respectively (P=0.33). Grade 3 pneumonitis was observed in 5.8% of FF patients and 3.4% of FFF patients (P=1.00). No other adverse events ≥grade 3 were observed. The results of the study suggest that VMAT‑SBRT using the FFF technique shortens the treatment time for lung SBRT while maintaining a high local control rate with low toxicity.
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Copy and paste a formatted citation
Spandidos Publications style
Aoki S, Yamashita H, Haga A, Nawa K, Imae T, Takahashi W, Abe O and Nakagawa K: Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique. Oncol Lett 15: 3928-3936, 2018.
APA
Aoki, S., Yamashita, H., Haga, A., Nawa, K., Imae, T., Takahashi, W. ... Nakagawa, K. (2018). Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique. Oncology Letters, 15, 3928-3936. https://doi.org/10.3892/ol.2018.7809
MLA
Aoki, S., Yamashita, H., Haga, A., Nawa, K., Imae, T., Takahashi, W., Abe, O., Nakagawa, K."Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique". Oncology Letters 15.3 (2018): 3928-3936.
Chicago
Aoki, S., Yamashita, H., Haga, A., Nawa, K., Imae, T., Takahashi, W., Abe, O., Nakagawa, K."Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique". Oncology Letters 15, no. 3 (2018): 3928-3936. https://doi.org/10.3892/ol.2018.7809
Copy and paste a formatted citation
x
Spandidos Publications style
Aoki S, Yamashita H, Haga A, Nawa K, Imae T, Takahashi W, Abe O and Nakagawa K: Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique. Oncol Lett 15: 3928-3936, 2018.
APA
Aoki, S., Yamashita, H., Haga, A., Nawa, K., Imae, T., Takahashi, W. ... Nakagawa, K. (2018). Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique. Oncology Letters, 15, 3928-3936. https://doi.org/10.3892/ol.2018.7809
MLA
Aoki, S., Yamashita, H., Haga, A., Nawa, K., Imae, T., Takahashi, W., Abe, O., Nakagawa, K."Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique". Oncology Letters 15.3 (2018): 3928-3936.
Chicago
Aoki, S., Yamashita, H., Haga, A., Nawa, K., Imae, T., Takahashi, W., Abe, O., Nakagawa, K."Flattening filter-free technique in volumetric modulated arc therapy for lung stereotactic body radiotherapy: A clinical comparison with the flattening filter technique". Oncology Letters 15, no. 3 (2018): 3928-3936. https://doi.org/10.3892/ol.2018.7809
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