Dosimetric comparison of volumetric modulated arc therapy and linear accelerator-based radiosurgery for the treatment of one to four brain metastases

被引:6
作者
Salkeld, Alison L. [1 ,2 ]
Unicomb, Kylie [1 ]
Hayden, Amy J. [1 ,2 ]
Van Tilburg, Kevin [1 ]
Yau, Shan [1 ,2 ]
Tiver, Kenneth [1 ,2 ]
机构
[1] Nepean Hosp, Nepean Canc Care Ctr, Sydney, NSW, Australia
[2] Westmead Hosp, Crowne Princess Mary Canc Ctr, Wentworthville, NSW 2145, Australia
关键词
brain; linear accelerator radiosurgery; metastasis; radiosurgery; volumetric modulated arc therapy; STEREOTACTIC RADIOSURGERY; RADIATION-THERAPY; BREAST-CANCER; RESECTION CAVITY; PLUS; PREDICTOR; SURGERY; QUALITY;
D O I
10.1111/1754-9485.12188
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Introduction: The purpose of this study is to compare and evaluate volumetric modulated arc therapy (VMAT) and linear accelerator-based radiosurgery (Linac RS) for the treatment of one to four brain metastases. Methods: Radiotherapy plans for 10 patients with 1 to 4 brain metastases that were planned and treated using conventional Linac RS were replanned using a mono-isocentric VMAT technique using two to four arcs. The same doses, target volumes and organs at risk (OAR) were used in both plans. The plans were evaluated for target volume coverage, dose conformity, homogeneity and dose to OAR. Results: For VMAT plans, 18/19 brain metastases met acceptable Radiation Therapy Oncology Group (RTOG) radiosurgery dose coverage, homogeneity and conformity criteria. There was no observed difference between the mean homogeneity indices for VMAT and Linac RS plans. VMAT plans had a lower mean RTOG conformity index compared with the Linac RS plans (1.10 +/- 0.06 versus 2.06 +/- 1.02). For the OAR, there was no difference in maximal doses to the brain stem, optic chiasm or optic nerves. The volume of normal brain receiving 12 Gy was lower in the VMAT plans (13.3 cm(3) versus 23.1 cm(3)) compared with the Linac RS plans. The mean total number of monitor units (MUs) was 31.3% less in the VMAT plans (5231.2 MU versus 3593.5 MU). Conclusions: Mono-isocentric VMAT plans using two to four arcs meet RTOG radiosurgery quality criteria in patients with one to four brain metastases, with an improvement in conformity and 12-Gy normal brain volume when compared with patients treated with Linac RS at our institution.
引用
收藏
页码:722 / 728
页数:7
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