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The purpose of this study is to give an exact formulation of optimization ofvolumetric-modulated arc therapy (VMAT) with sliding-window delivery, and toinvestigate the plan quality effects of decreasing the number of sliding-windowsweeps made on the 360-degree arc for a faster VMAT treatment. In light of theexact formulation, we interpret an algorithm previously suggested in theliterature as a heuristic method for solving this optimization problem. Byfirst making a generalization, we suggest a modification of this algorithm forbetter handling of plans with fewer sweeps. In a numerical study involving oneprostate and one lung case, plans with varying treatment times and number ofsweeps are generated. It is observed that, as the treatment time restrictionsbecome tighter, fewer sweeps may lead to better plan quality. Performance ofthe original and the modified version of the algorithm is evaluated inparallel. Applying the modified version results in better objective functionvalues and less dose discrepancies between optimized and accurate dose, and theadvantages are pronounced with decreasing number of sweeps.

On tradeoffs between treatment time and plan quality of volumetric-modulated arc therapy with sliding-window delivery