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. 2019 Oct 15;10(24):6135-6141.
doi: 10.7150/jca.32500. eCollection 2019.

Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Chengqiang Li  1 , Jinhu Chen  1 , Jian Zhu  1 , Guanzhong Gong  1 , Cheng Tao  1 , Zhenjiang Li  1 , Jie Lu  1 , Yong Yin  1
Affiliations

Plan quality comparison for cervical carcinoma treated with Halcyon and Trilogy intensity-modulated radiotherapy

Chengqiang Li et al. J Cancer. .

Abstract

Purpose: Varian Halcyon is a novel machine with dual-layer leaves, single flattening filter free (FFF) energy and an enclosed bore. The purpose of this study was to compare the differences in dosimetry and plan parameters of intensity-modulated radiation therapy (IMRT) plans between the Halcyon and Trilogy accelerators. Methods and Materials: A total of 30 IMRT plans from cervical carcinoma patients were retrospectively analyzed on the Trilogy and Eclipse v13.5 treatment planning systems (TPSs). For each patient, a new plan based on Halcyon was created with the same planning parameters and optimization constraints using the Eclipse Version 15.1 TPS. To compare plan qualities, dosimetry parameters regarding planning target volume (PTV), organs at risk (OARs), monitor unit (MU) efficiency, segment size and treatment time were evaluated. Evaluation of the helical diode array system was performed with gamma-index analysis. Results: The dose distribution of the target volume of the Halcyon and Trilogy plans showed no significant difference (p > 0.05). The mean doses of rectum and both femoral heads for Halcyon plans were significantly reduced compared to those for Trilogy plans (p < 0.05). Compared to Trilogy, Halcyon increased the number of MUs from 1542.9±248.3 MU to 2514.9±328.2 MU (p = 0.00) and decreased the delivery time from 11.28±1.36 min to 3.26±0.26 min (p = 0.00). The average segment areas of Halcyon plans for proximal and distal multileaf collimators (MLCs) were 42.1 ± 31.2 cm2 and 28.4 ± 23.7 cm2, respectively, and that of Trilogy plans was 27.3 ± 16.9 cm2. The mean gamma index (3 mm/3%) results for the Halcyon and Trilogy plans were 99.41±0.26 and 99.76±0.32 (p > 0.05), respectively. Conclusions: All Halcyon treatment plans were recognized as clinically acceptable and had statistically better OAR sparing with higher delivery efficiency. The Halcyon system exhibited fast treatment delivery of IMRT with good dosimetric agreement using ArcCHECK.

Keywords: Dual-layer MLC; Flattening filter free; Intensity-modulated radiotherapy; Segment area.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
The mean DVHs of PTV averaged over 30 patients for the Trilogy (black solid) and Halcyon (red dashed) plans
Figure 2
Figure 2
The mean DVHs of OARs averaged over 30 patients for the Trilogy (black solid) and Halcyon (red dashed) plans.
Figure 3
Figure 3
Comparison of MUs (a), segment areas (b) and the segment area ratio of proximal MLC to distal MLC (c) for 30 patients.
See this image and copyright information in PMC

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