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The plan quality and performance of dual arc\u2010VMAT (DA\u2010VMAT) using the <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/acm20158-math-0001.png\" xlink:title=\"urn:x-wiley:15269914:acm20158:equation:acm20158-math-0001\"\/> Smart\u2010Arc system (clinical version 9.0; Philips, Fitchburg, WI, USA) were evaluated and compared with those of seven\u2010field (7F)\u2010IMRT in 18 consecutive NPC patients. Analysis parameters included the conformity index (CI) and homogeneity index (HI) for the planning target volume (PTV), maximum and mean dose, normal tissue complication probability (NTCP) for the specified organs at risk (OARs), and comprehensive quality index (CQI) for an overall evaluation in the 11 OARs. Treatment delivery time, monitor units per fraction (MU\/fr), and gamma <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/acm20158-math-0002.png\" xlink:title=\"urn:x-wiley:15269914:acm20158:equation:acm20158-math-0002\"\/> evaluations were also analyzed. DA\u2010VMAT achieved similar target coverage and slightly better homogeneity than conventional 7F\u2010IMRT with a similar CI and HI. NTCP values were only significantly lower in the left parotid gland (for xerostomia) for DA\u2010VMAT plans. The mean value of CQI at <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/acm20158-math-0003.png\" xlink:title=\"urn:x-wiley:15269914:acm20158:equation:acm20158-math-0003\"\/> indicated a 2% benefit in sparing OARs by DA\u2010VMAT. The MU\/fr used and average delivery times appeared to show improved efficiencies in DA\u2010VMAT. Each technique demonstrated high accuracy in dose delivery in terms of a high\u2010quality assurance (QA) passing rate <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/acm20158-math-0004.png\" xlink:title=\"urn:x-wiley:15269914:acm20158:equation:acm20158-math-0004\"\/> of the <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/acm20158-math-0005.png\" xlink:title=\"urn:x-wiley:15269914:acm20158:equation:acm20158-math-0005\"\/> criterion. The major difference between DA\u2010VMAT and 7F\u2010IMRT using a sequential mode for treating NPC cases appears to be improved efficiency, resulting in a faster delivery time and the use of fewer MU\/fr.<\/jats:p><jats:p>PACS number: 87.53.Tf, 87.55.x, 87.55.D, 87.55.dk<\/jats:p>","DOI":"10.1120\/jacmp.v12i4.3587","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T22:33:03Z","timestamp":1488234783000},"page":"158-174","source":"Crossref","is-referenced-by-count":52,"title":["Comparative analysis of SmartArc\u2010based dual arc volumetric\u2010modulated arc radiotherapy (VMAT) versus intensity\u2010modulated radiotherapy (IMRT) for nasopharyngeal carcinoma"],"prefix":"10.1002","volume":"12","author":[{"given":"Tsair\u2010Fwu","family":"Lee","sequence":"first","affiliation":[{"name":"Medical Physics &amp; Informatics Lab., Department of Electronics Engineering National Kaohsiung University of Applied Sciences  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