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Accurate Tracking of Position and Dose during Abdominal Cancer Treatment based on IMRT and VMAT Techniques |
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PP: 197-207 |
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doi:10.18576/jrna/100213
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Author(s) |
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Rania Abdelrahman,
Khaled. M. El-Shahat,
Mostafa Abdelwanis,
Hany El-Gamal,
Wafaa Rashed,
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Abstract |
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| The treatment planning process is the core of radiotherapy for malignancy treatment, it is an essential tool for optimal beam arrangements, energies, field sizes, and ultimately fluence pattern to produce a safe and effective dose distribution for achieving therapeutic goal which maximize the dose covered the planning tumor volume PTV and minimize the dose delivered to the surrounding normal tissue. This study evaluates real-time tumor tracking (RTRT) in SBRT-VMAT for hepatocellular carcinoma (HCC) to address tumor motion challenges in conventional IMRT. Twenty HCC patients treated with IMRT were replanned using SBRT-VMAT with RTRT to compare dosimetric outcomes, focusing on PTV coverage and OAR sparing. RTRT enabled reduced PTV margins by mitigating setup errors and organ motion, enhancing targeting precision. SBRT-VMAT plans achieved superior dose conformity (CI) and homogeneity (HI) compared to IMRT, with improved tumor coverage (CO). Normal liver tissue receiving >15 Gy was significantly reduced using SBRT-VMAT, preserving liver function in patients with compromised hepatic health. Critical OARs (spinal cord, esophagus, stomach, and small intestine) showed reduced radiation exposure with SBRT-VMAT.RTRT integration ensured accurate tumor localization without additional radiation dose during tracking. Shorter treatment delivery times and higher dose conformity make SBRT-VMAT clinically efficient for mobile upper abdominal tumors. The study demonstrates SBRT-VMAT with RTRT as a safer, more precise option for HCC, particularly in patients with limited liver reserve. Findings support adopting RTRT-guided SBRT-VMAT to optimize therapeutic ratios by sparing healthy tissues while maintaining tumor control. |
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