Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-28T08:57:10.776Z Has data issue: false hasContentIssue false
  • English
  • Français

A dosimetric comparison of craniospinal irradiation using TomoDirect radiotherapy, TomoHelical radiotherapy and 3D conventional radiotherapy

Published online by Cambridge University Press:  22 June 2017

Shirley W. S. Tsang ,
Mark Collins ,
Jacky T. L. Wong  and
George Chiu
Shirley W. S. Tsang
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
Mark Collins*
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
Jacky T. L. Wong
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
George Chiu
Affiliation:
Department of Radiotherapy, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
*
Correspondence to: Mark Collins, Faculty of Health and Wellbeing, Sheffield Hallam University, F423 Robert Winston Building, Collegiate Crescent Campus, Sheffield, S10 2BP, UK. Tel: +44 114 225 5555. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

The purpose of this study was to dosimetrically compare TomoDirect, TomoHelical and linear accelerator-based 3D-conformal radiotherapy (Linac-3DCRT) for craniospinal irradiation (CSI) in the treatment of medulloblastoma.

Methods

Five CSI patients were replanned with Linac-3DCRT, TomoHelical, TomoDirect-3DCRT and TomoDirect-intensity-modulated radiotherapy (IMRT). Dose of 36 Gy in 20 fractions was prescribed to the planning target volume (PTV). Homogeneity index (HI), non-target integral dose (NTID), dose–volume histograms, organs-at-risk (OARs) Dmax, Dmean and treatment times were compared.

Results

TomoHelical achieved the best PTV homogeneity compared with Linac-3DCRT, TomoDirect-3DCRT and TomoDirect-IMRT (HI of 3·6 versus 20·9, 8·7 and 9·4%, respectively). TomoDirect-IMRT achieved the lowest NTID compared with TomoDirect-3DCRT, TomoHelical and Linac-3DCRT (141 J versus 151 J, 181 J and 250 J), indicating least biological damage to normal tissues. TomoHelical plans achieved the lowest Dmax in all organs except the breasts, and lowest Dmean for most OARs, except in laterally situated OARs, where TomoDirect triumphed. Beam-on time was longest for TomoHelical, followed by TomoDirect and Linac-3DCRT.

Findings

TomoDirect has the potential to lower NTID and shorten treatment times compared with TomoHelical. It reduces PTV inhomogeneity and better spares OARs compared with Linac-3DCRT. Therefore, TomoDirect may be a CSI treatment alternative to TomoHelical and in place of Linac-3DCRT.

Keywords

3DCRTcraniospinal irradiationTomoDirecttomotherapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 4 , December 2017 , pp. 391 - 402
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Brodin, N P, Munck Af Rosenschold, P, Aznar, M C et al. Radiobiological risk estimates of adverse events and secondary cancer for proton and photon radiation therapy of pediatric medulloblastoma. Acta Oncol 2011; 50 (6): 806–816.Google Scholar
2. GLOBOCAN. GLOBOCAN 1: cancer incidence and mortality worldwide. J Clin Pathol 2000; 53 (2): 164.Google Scholar
3. Lopez Guerra, J L, Marrone, I, Jaen, J et al. Outcome and toxicity using helical tomotherapy for craniospinal irradiation in pediatric medulloblastoma. Clin Transl Oncol 2014; 16 (1): 96–101.Google Scholar
4. Packer, R J, Gajjar, A, Vezina, G et al. Phase III study of craniospinal radiation therapy followed by adjuvant chemotherapy for newly diagnosed average-risk medulloblastoma. J Clin Oncol 2006; 24 (25): 4202–4208.Google Scholar
5. Ostrom, Q T, Gittleman, H, Liao, P et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007–2011. Neuro Oncol 2014; 16 (suppl 4): iv1–iv63.Google Scholar
6. Fossati, P, Ricardi, U, Orecchia, R. Pediatric medulloblastoma: toxicity of current treatment and potential role of protontherapy. Cancer Treat Rev 2009; 35 (1): 79–96.Google Scholar
7. Myers, P A, Mavroidis, P, Papanikolaou, N, Stathakis, S. Comparing conformal, arc radiotherapy and helical tomotherapy in craniospinal irradiation planning. J Appl Clin Med Phys 2014; 15 (5): 4724.Google Scholar
8. Barrett, A. Practical Radiotherapy Planning, 4th edition. London: Hodder Arnold, 2009; viii, 468 pp., 20–21, 214–215.Google Scholar
9. Penagaricano, J, Moros, E, Corry, P, Saylors, R, Ratanatharathorn, V. Pediatric craniospinal axis irradiation with helical tomotherapy: patient outcome and lack of acute pulmonary toxicity. Int J Radiat Oncol Biol Phys 2009; 75 (4): 1155–1161.Google Scholar
10. Huang, F, Parker, W, Freeman, C R. Feasibility and early outcomes of supine-position craniospinal irradiation. Pediatr Blood Cancer 2010; 54 (2): 322–325.Google Scholar
11. Parker, W, Brodeur, M, Roberge, D, Freeman, C. Standard and nonstandard craniospinal radiotherapy using helical TomoTherapy. Int J Radiat Oncol Biol Phys 2010; 77 (3): 926–931.Google Scholar
12. Sugie, C, Shibamoto, Y, Ayakawa, S et al. Craniospinal irradiation using helical tomotherapy: evaluation of acute toxicity and dose distribution. Technol Cancer Res Treat 2011; 10 (2): 187–195.Google Scholar
13. TomoTherapy Treatment System. Tomo Planning Guide 105191A TomoHD Version 1.0.x. Madison, WI: TomoTherapy Incorporated, 2010.Google Scholar
14. Kim, J, Jeong, K, Chung, Y et al. Feasibility of TomoDirect 3D-conformal radiotherapy for craniospinal irradiation. Int J Radiat Oncol 2010; 78 (3): S828.Google Scholar
15. Langner, U W, Molloy, J A, Gleason, J F Jr, Feddock, J M. A feasibility study using TomoDirect for craniospinal irradiation. J Appl Clin Med Phys 2013; 14 (5): 104–114.Google Scholar
16. Patil, V M, Oinam, A S, Chakraborty, S, Ghoshal, S, Sharma, S C. Shielding in whole brain irradiation in the multileaf collimator era: dosimetric evaluation of coverage using SFOP guidelines against in-house guidelines. J Cancer Res Ther 2010; 6 (2): 152–158.Google Scholar
17. Patel, S, Drodge, S, Jacques, A, Warkentin, H, Powell, K, Chafe, S. A comparative planning analysis and integral dose of volumetric modulated arc therapy, helical tomotherapy, and three-dimensional conformal craniospinal irradiation for pediatric medulloblastoma. J Med Imaging Radiat Sci 2015; 46: 134–140.Google Scholar
18. Nakamura, N, Shikama, N, Wada, H et al. Variability in the point to which single direct field irradiation is prescribed for spinal bone metastases: a survey of practice patterns in Japan. J Radiat Res 2013; 54 (6): 1065–1068.Google Scholar
19. Gupta, T, Sarin, R. Palliative radiation therapy for painful vertebral metastases: a practice survey. Cancer 2004; 101 (12): 2892–2896.Google Scholar
20. Marks, L B, Yorke, E D, Jackson, A et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys 2010; 76 (3 suppl): S10–S19.Google Scholar
21. Roesink, J M, Moerland, M A, Battermann, J J, Hordijk, G J, Terhaard, C H. Quantitative dose-volume response analysis of changes in parotid gland function after radiotherapy in the head-and-neck region. Int J Radiat Oncol Biol Phys 2001; 51 (4): 938–946.Google Scholar
22. Société Française de Radiothérapie Oncologique (SFRO). Guide des procédures de radiothérapie externe 2007, 2007. http://www.has-sante.fr/portail/upload/docs/application/pdf/2008-08/guide_de_rth_des_tumeurs_v7_complet.pdf. Accessed on 20th April 2015.Google Scholar
23. Verellen, D, Vanhavere, F. Risk assessment of radiation-induced malignancies based on whole-body equivalent dose estimates for IMRT treatment in the head and neck region. Radiother Oncol 1999; 53 (3): 199–203.Google Scholar
24. Yoon, M, Shin, D H, Kim, J et al. Craniospinal irradiation techniques: a dosimetric comparison of proton beams with standard and advanced photon radiotherapy. Int J Radiat Oncol Biol Phys 2011; 81 (3): 637–646.Google Scholar
25. Mayneord, W V. The measurement of radiation for medical purposes. Proceedings of the Physical Society, 1942; 54: 405–421.Google Scholar
26. Nguyen, F, Rubino, C, Guerin, S et al. Risk of a second malignant neoplasm after cancer in childhood treated with radiotherapy: correlation with the integral dose restricted to the irradiated fields. Int J Radiat Oncol Biol Phys 2008; 70 (3): 908–915.Google Scholar
27. Hall, E J, Wuu, C S. Radiation-induced second cancers: the impact of 3D-CRT and IMRT. Int J Radiat Oncol Biol Phys 2003; 56 (1): 83–88.Google Scholar
28. Barra, S, Gusinu, M, Cavagnetto, F et al. Comparison of treatment plans between 3D-CRT and helical tomotherapy based on integral dose delivered to pediatric patients receiving craniospinal irradiation. Int J Radiat Oncol Biol Phys 2010; 78 (3): S594.Google Scholar
29. Sharma, D S, Gupta, T, Jalali, R, Master, Z, Phurailatpam, R D, Sarin, R. High-precision radiotherapy for craniospinal irradiation: evaluation of three-dimensional conformal radiotherapy, intensity-modulated radiation therapy and helical TomoTherapy. Br J Radiol 2009; 82 (984): 1000–1009.Google Scholar
30. Stovall, M, Smith, S A, Langholz, B M et al. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study. Int J Radiat Oncol Biol Phys 2008; 72 (4): 1021–1030.Google Scholar
31. Srivastava, R, Saini, G, Sharma, P K et al. A technique to reduce low dose region for craniospinal irradiation (CSI) with RapidArc and its dosimetric comparison with 3D conformal technique (3DCRT). J Cancer Res Ther 2015; 11 (2): 488–491.Google Scholar