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Volumetric modulated arc therapy (VMAT): a review of clinical outcomes—what is the clinical evidence for the most effective implementation?

Hunte, Sherisse Ornella; Clark, Catharine H; Zyuzikov, Nikolay; Nisbet, Andrew; (2022) Volumetric modulated arc therapy (VMAT): a review of clinical outcomes—what is the clinical evidence for the most effective implementation? British Journal of Radiology , 95 (1136) , Article 20201289. 10.1259/bjr.20201289. Green open access

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Abstract

Modern conformal radiation therapy using techniques such as modulation, image guidance and motion management have changed the face of radiotherapy today offering superior conformity, efficiency, and reproducibility to clinics worldwide. This review assesses the impact of these advanced radiotherapy techniques on patient toxicity and survival rates reported from January 2017 to September 2020. The main aims are to establish if dosimetric and efficiency gains correlate with improved survival and reduced toxicities and to answer the question 'Has VMAT become the gold standard of radiotherapy?'. Compared with 3DCRT, improvements have been reported with VMAT in prostate, locally advanced cervical carcinoma and various head and neck applications which leading to the shift in technology to VMAT. Other sites have observed improvement with VMAT however, the burden of toxicity and the incidence of cancer related deaths remain high signalling the need to further mitigate toxicity and increase survival. As technological advancement continues, large randomized long-term clinical trials are required to determine the way-forward and offer site-specific recommendations. These studies are usually expensive and time consuming therefore utilizing pooled real-world data in a prospective nature can be an alternative solution to comprehensively assess the efficacy of modern radiotherapy techniques.

Type: Article
Title: Volumetric modulated arc therapy (VMAT): a review of clinical outcomes—what is the clinical evidence for the most effective implementation?
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1259/bjr.20201289
Publisher version: https://doi.org/10.1259/bjr.20201289
Language: English
Additional information: This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
UCL classification: UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10150120
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