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Optimising craniospinal irradiation for medulloblastoma: a dosimetric comparison of two VMAT planning methods.
Thakur, Niketa; Bansal, Nancy; Sudan, Meena; Sharma, Abhishek.
Afiliación
  • Thakur N; Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Bilaspur 174037, India.
  • Bansal N; Department of Radiation Oncology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar 143501, India.
  • Sudan M; Department of Radiation Oncology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar 143501, India.
  • Sharma A; Department of Anesthesia and Critical Care, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India.
Ecancermedicalscience ; 18: 1700, 2024.
Article en En | MEDLINE | ID: mdl-38774570
ABSTRACT

Background:

Craniospinal irradiation (CSI) poses a challenging planning process because of the complex target volume. Traditional 3D conformal CSI does not spare any critical organs, resulting in toxicity in patients. Here the dosimetric advantages of volumetric-modulated arc therapy (VMAT) using partial arc and avoidance sectors are compared with each other in planning in adult patients undergoing CSI to develop a clinically feasible technique that is both effective and efficient. Patient and

methods:

Eight adult patients treated with CSI were retrospectively identified. In total 16 plans were made. We generated two plans for each patient 1. VMAT plan using partial arc, namely VMAT_pa. 2. VMAT plan using avoidance sectors, namely VMAT_as. The dose prescribed was 36 Gy in 20 fractions. The dose-volume histogram for planning target volume (PTV) and organs at risk (OAR) (lens, eye, heart, thyroid, lungs, liver, gonads and kidneys) were analysed and compared. Dose parameters of mean dose, V95%, and V107% for the PTV were evaluated.

Results:

The median length of PTV is 65.58 cm (45.8-79.5). The volume of PTV receiving 95% of the dose (V95%) in both the plans are 97.51% (VMAT_as) and 97.99% (VMAT_pa) (p = 0.121) while V107% are 0.733 and 0.742 for VMAT_as and VMAT_pa, respectively (p = 0.969). The doses of OARs such as lens, eye, liver and gonads were comparable. The mean heart dose was 10.4 and 9.0 Gy in VMAT_as and VMAT_pa plans, respectively (p = 0.005). Significant lower doses to the thyroid, kidneys and lungs were seen in VMAT plans using avoidance sectors.

Conclusion:

This study provides a practically useful VMAT planning method for the treatment of CSI and illustrates the ability of VMAT using avoidance sectors to generate highly conformal and homogeneous treatment plans for CSI, while limiting the dose to the relevant OARs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ecancermedicalscience Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ecancermedicalscience Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: Reino Unido