{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T22:30:31Z","timestamp":1783549831425,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We performed scalp\u2010avoidance whole\u2010brain irradiation with volumetric\u2010modulated arc therapy (SAWB\u2010VMAT) as a component of craniospinal irradiation. In SAWB\u2010VMAT with two coplanar arcs, radiation oncologists and medical physicists sometimes experience difficulty in reducing the dose to the scalp to below the cut\u2010off equivalent dose in 2\u00a0Gy per fraction (assuming \u03b1\/\u03b2\u00a0=\u00a02) to 50% (EQD50%<jats:sub>scalp<\/jats:sub>). To investigate the advantage of adding coplanar or non\u2010coplanar arcs in reducing the dose to the scalp in SAWB\u2010VMAT, we conducted a planning study to compare the EQD50%<jats:sub>scalp<\/jats:sub>, the dose to other organs at risk (OARs), and target coverage in VMAT with two coplanar arcs (Co2arcVMAT), VMAT with three coplanar arcs (Co3arcVMAT), and VMAT with two coplanar and two non\u2010coplanar arcs (NcVMAT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Co2arcVMAT, Co3arcVMAT, and NcVMAT plans were created for 10 pediatric patients with medulloblastoma. The planned target volume (PTV) included the regions of the whole brain, cervical spinal cord, cerebrospinal fluid space, and intervertebral foramen. The EQD50%<jats:sub>scalp<\/jats:sub> was evaluated separately for four areas (top, back, left, and right) in each case. The prescribed dose for the PTV was 35.2\u00a0Gy in 22 fractions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median EQD50%<jats:sub>scalp<\/jats:sub> of the top area was 21.9\u00a0, 22.1\u00a0, and 18.3\u00a0Gy for Co2arcVMAT, Co3arcVMAT, and NcVMAT, respectively. The EQD50%<jats:sub>scalp<\/jats:sub> of the top area was significantly reduced in NcVMAT compared to those in Co2arcVMAT and Co3arcVMAT (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). The median EQD50%<jats:sub>scalp<\/jats:sub> of the top area for NcVMAT was\u00a0&lt;\u00a019.9\u00a0Gy, which is the cut\u2010off dose for severe permanent alopecia. There were no significant differences in EQD50%<jats:sub>scalp<\/jats:sub> in the three other areas, the dose to other OARs, or the dose coverage of PTV among the three techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NcVMAT could reduce the EQD50%<jats:sub>scalp<\/jats:sub> of the top area below the cut\u2010off dose of 19.9\u00a0Gy. NcVMAT appears to be a promising treatment technique for SAWB\u2010VMAT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14189","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T20:14:44Z","timestamp":1698956084000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dosimetric impact of adding non\u2010coplanar arcs for scalp\u2010avoidance whole\u2010brain irradiation with volumetric\u2010modulated arc radiotherapy on scalp dose reduction in pediatric patients with medulloblastomas"],"prefix":"10.1002","volume":"25","author":[{"given":"Daichi","family":"Torizuka","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010applied therapy Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Uto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010applied therapy Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-8746","authenticated-orcid":false,"given":"Takashi","family":"Mizowaki","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010applied therapy Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(06)70867-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.4980"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.9984"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.04.031"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22992"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200304110-00004"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2023.01.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12748"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-016-0659-x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v13i4.3826"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2021.02.007"},{"issue":"5","key":"e_1_2_10_13_1","first-page":"1395","article-title":"Dosimetric comparison between single and dual arc\u2010volumetric modulated arc radiotherapy and intensity modulated radiotherapy for nasopharyngeal carcinoma using a simultaneous integrated boost technique","volume":"18","author":"Radhakrishnan S","year":"2017","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/153303460500400510"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-015-0555-9"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.supplement_3.0219"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jicru_ndq025"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.14189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T13:51:24Z","timestamp":1707745884000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.14189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,2]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/acm2.14189"],"URL":"https:\/\/doi.org\/10.1002\/acm2.14189","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,2]]},"assertion":[{"value":"2023-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14189"}}