Abstract
Purpose: To evaluate the effects of variable versus constant dose rate in volumetric modulated arc (VMAT) treatment planning for prostate cases. Method and Materials:A retrospective investigation on fifteen prostate cases was performed. Two dosimetrically identical linacs were commissioned in Pinnacle TPS. One machine was variable dose rate capable, while the other was constant dose rate capable for VMAT planning purposes. PTVs and OARs (rectum and bladder) were delineated for each case. Two VMAT plans were generated per case: each comprised of a single arc and comparing variable to constant dose rate. Both plans were normalized such that 95% of the PTV was covered by the same prescription dose. Plan quality was evaluated by several dose indices used as DVH objectives in the inverse optimization. In addition, dose inhomogeneity across the PTV was tallied together with MUs and estimated treatment times. Variable dose rare plans were used as reference. Results: The majority of rectum and bladder doses to 10%, 20%, and 40% of the OAR volumes differed by less than 3% between the two plans plans. Even for the cases with larger than 3% deviation the constant dose rate plans were clinically acceptable. Dose inhomogeneity across the PTV however was larger for constant dose rate plans, where for 80% of the cases it was over 3%, while it was within 3% for all variable dose rate cases. The MUs for the two delivering modes were comparable, while the treatment times differed three‐fold. Conclusions: The results indicate that variable and constant dose rate VMAT plans for prostate carcinoma result in comparable target coverage and OAR sparing. Nonetheless, the constant dose rate plans exhibit higher dose inhomogeneity across the target and the clinical applicability should be carefully evaluated for the potential hotspots in undesired location.
