Usefulness Evaluation on the Treatment Plan of Tomotherapy and VMAT in Radiotherapy for Prostate Cancer

전립선암의 방사선치료에서 토모테라피와 VMAT의 치료계획에 따른 유용성 평가

Heo, Kwangmyoung;Han, Jaebok;Choi, Namgil

  • Received : 2015.09.23
  • Accepted : 2015.12.25
  • Published : 2015.12.31


In this study, to evaluate the usefulness of the treatment plan of tomotherapy and volumetric modulated arc therapy (VMAT) in the radiotherapy for prostate cancer, the absorbed dose, dose volume histogram (DVH), treatment efficiency, and the results of dose verification accuracy using MapCHECK2 were compared and analyzed. Of the prostate cancer patients who underwent tomotherapy treatment in the Radiologic Oncology of H University Hospital between July 2014 and December 2014, 12 patients were randomly selected. As a result of analyzing the absorbed dose and DVH, both radiologic treatment plans showed slight differences in the treatment of the cancer tissues and the bladder, but the difference was in the error range of -5% to +3%, and did not exceed the side effect guideline or the tolerance dose limit. VMAT showed higher treatment efficiency than tomotherapy with a 2.5 times shorter treatment time and a 10.3 times less monitor unit (MU). Both showed 95% or higher dose accuracy satisfying the standard. VMAT showed 2.3% higher efficiency than tomotherapy. In both tomotherapy and VMAT, appropriate doses were absorbed for cancer tissues, and did not exceed the tolerance dose for normal tissues showing no significant difference in dose distribution. However, considering the shorter treatment time, lower total MU, and better treatment efficiency and dose verification accuracy, VMAT may be more useful than tomotherapy in cancer treatments.


Prostate cancer;Tomotherapy;VMAT;MapCHECK2


  1. W. Park, "Radiotherapy for prostate cancer", J Korean Med Assoc, Vol. 58, No. 1, pp.21-29, 2015.
  2. M. J. Zelefsky, S. A. Leibel, P. B. Gaudin. et al, "Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer", Int J Radiat Oncol Biol Phys, Vol. 41, No. 3, pp.491-500, 1998.
  3. Intensity Modulated Radiation Therapy Collaborative Working Group, "Intensity modulated radiotherapy", Current status and issues of interest. Int J Radiat Oncol Biol Phys, Vol. 51, pp. 880-917, 2001.
  4. C. C. Ling, C. Burma, C. S. Cui, et al, "Conformal radiation treatment of prostate cancer using inversely-planned intensity-modulated photon beams produced with dynamic multileaf collimation", Int J Radiat Oncol Biol Phys, Vol. 32, pp.721-730, 1996.
  5. J. Balog, G. Olovera, J. Kapatoes, "Clinical helical tomotherpay commissioning dosimetry", Medical physics, Vol. 30, No. 12, pp.3097-3106, 2003.
  6. J. Y. Kim, C. S. Kay, Y. S. Kim, et al, "Helical tomotherapy for simultaneous multitarget radiotherapy for pulmonary metastasis", Int J Radiat Oncol Biol Phys, Vol. 75, No. 3, pp.703-710, 2009.
  7. H. S. Kim, "Anticancer drug use and out- of-pocket money burden in Korean cancer patients: A questionnaire study", Korean journal of clinical pharmacy, Vol. 22, No. 3, pp.239-250, 2012.
  8. Y. C. Ahn, "Introduction of intensity modulated radiation therapy", J korean Med Assoc, Vol. 54, No. 11, pp.72-1178, 2011.
  9. B. Emami, J. Lyman, A. Brown, et al, "Tolerance of normal tissue to therapeutic irradiation", Int J Radiat Oncol Biol Phys, Vol. 21, pp.109-122, 1991.
  10. S. Ayakawa, C. Sugie, F. Baba, et al, "Volumetric Modulated Arc Therapy (VMAT) Versus Helical Tomotherapy (HT) for Localized Prostate Cancer: Dosimetric Comparison by Using the Identical Prescription Dose to the Prostate", Vol. 87, No. 2, pp.S375-S375, 2013.
  11. Y. J. Kim, G. U. Seol, "The Study of Dose Distribution according to the Using Linac and Tomotherapy on total Lymphnode Irradiation", Journal of the Korean Society of Radiology, Vol. 7, No. 4, pp.285-291, 2013.
  12. S. D. Kim, "What's New in Radiation Therapy for High Risk Prostate Cancer", Korean J Urol Oncol, Vol. 12, No. 3, pp.106-111, 2014.
  13. C. L Tsai, Jian-Kuen, H, L Chao, et al, "Treatment and Dosimetric Advantagess Between VMAT, IMRT, and Helical Tomotherapy in Prostate Cancer", Medical Dosimetry, Vol. 36, No. 3, pp. 264-271, 2011.
  14. M. Rao, W. Yang, F. Chen, et al, "Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT:Plan quality, delivery efficiency and accuracy", Medical Physics, Vol. 37, No. 3, pp.1350-1359, 2010.
  15. Y. Xie, D. Djajaputra, C. R. King et al, intrafractional motion of the prostate during hypofractionated radiotherapy", Int J Radiat Oncol Biol Phys, Vol. 72, pp.236-246, 2010.
  16. I. Gudowska, A. Brahme, P. Andreo, et al, "Calculation of absorbed dose andbiological effectiveness from photonuclear reactions in a bremsstrahlung beam of end point 50 MeV", Phys, Med, Bio, Vol. 44, No. 9, pp.2099-125, 1999.
  17. S. F. Kry, M. Salehpour, D. S. Followill et al, "The calculated risk of fatal secondary malignancies from intensity-modulated radiation therapy", Int J Radiat Oncol Biol Phys, Vol. 62, pp.1195-1203, 2005.
  18. F. C. Henriquez, S. V. Castrillon, "A probability approach to the study on uncertainty effects on gamma index eveluations in radiation therap", Computational and Mathematical Methods in Medicine, Vol. 2011, pp.1-10, 2011.
  19. L. Daniel, G. Misbah, Y. Di, et al, "Evaluation of a 2D diode array for IMRT quality assurance", Radiation & Oncology, Vol. 70, pp.199-206, 2004.

Cited by

  1. A Monte Carlo Study of Secondary Electron Production from Gold Nanoparticle in Kilovoltage and Megavoltage X-rays vol.10, pp.3, 2016,