Fuli Zhang,Huayong Jiang,Weidong Xu,Yadi Wang,Junmao Gao,Qingzhi Liu,Ping Wang,Na Lu,Diandian Chen,Bo Yao,Jun Hou,Heliang He,Jianping Chen. A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy for postoperative treatment of cervical cancer. Oncol Transl Med, 2016, 2: 179-184.
A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy for postoperative treatment of cervical cancer
Received:March 26, 2016  Revised:July 24, 2016
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KeyWord:flattening filter-free (FFF); cervical cancer; dosimetry; volumetric modulated arc therapy (VMAT)
Author NameAffiliationE-mail
Fuli Zhang Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China radiozfli@163.com 
Huayong Jiang Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China doctorjhy@163.com 
Weidong Xu Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China xwddc@126.com 
Yadi Wang Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China wangyadi@hotmail.com 
Junmao Gao Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China gaojunmao1962@163.com 
Qingzhi Liu Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China liu2qing1zhi4@126.com 
Ping Wang Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China wangping1956@163.com 
Na Lu Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China zeng@163.com 
Diandian Chen Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China zeng1@163.com 
Bo Yao Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China zeng2@163.com 
Jun Hou Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China zgeng3@163.com 
Heliang He Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China zgeng4@163.com 
Jianping Chen Radiation Oncology Department, The PLA Army General Hospital of China, Beijing 100700, China zgeng5@163.com 
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Abstract:
      Objective: The aim of the study was to compare flattening filter-free (FFF) beams and conventional flattening filter (FF) beams in volumetric modulated arc therapy (VMAT) for cervical cancer after surgery, through a retrospective planning study. Methods: VMAT plans of FFF beams and normal FF beams were designed for a cohort of 15 patients. The prescribed dose was 45 Gy to 1.8 Gy per fraction, and at least 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system using a Monte Carlo (MC) algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices (HI and CI), as well as organs at risk (OAR) dose and volume parameters. Results: FFF-VMAT was similar to FF-VMAT in terms of CI, but inferior to FF-VMAT considering HI. No statistically differences were observed between FFF-VMAT and FF-VMAT in following organ at risks including pelvic bone marrow, small bowel, bladder, rectum, and normal tissue (NT). . Conclusion: For patients with cervical cancer after hysterectomy, the FFF beam achieved target and OAR dose distribution similar to that of the FF beam. Reduction of beam-on time in cervical cancer is beneficial.
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