Volumetric intensity-modulated arc therapy (RA) allows for rapid delivery of highly
conformal dose distributions. In this study, planning and dosimetry of RA were compared
with conventional intensity-modulated radiation therapy (IMRT) plans of head-and-neck
Computed tomography scans of 12 patients who had completed IMRT for advanced tumors
of the naso-, oro- and hypopharynx were replanned using RA using either one or two
arcs. Calculated doses to planning target volume (PTV) and organs at risk (OAR) were
compared between IMRT and RA plans. Dose distributions for single arc (n = 8) and
double arc (n = 4) plans were verified using film dosimetry in three to five coronal
planes using a quality assurance phantom.
RA plans allowed for a mean reduction in number of monitor units (MU) by nearly 60%,
relative to seven field sliding window IMRT plans. RA plans achieved similar sparing
of all OAR as IMRT. Double arc RA provided the best dose homogeneity to PTV with a
lower standard deviation of PTV dose (1.4 Gy), vs. single arc plans (2.0 Gy) and IMRT
(1.7 Gy). Film measurements showed good correspondence with calculated doses; the
mean gamma value was 0.30 (double arc) and area of the film with a gamma exceeding
1 was 0.82%.
RA is a fast, safe, and accurate technique that uses lower MUs than conventional IMRT.
Double arc plans provided at least similar sparing of OAR and better PTV dose homogeneity
than single arc or IMRT.