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Dosimetric comparison of integral dose for different techniques of craniospinal irradiation

Published online by Cambridge University Press:  09 June 2020

Brijesh Goswami Open the ORCID record for Brijesh Goswami [Opens in a new window] ,
Rakesh Kumar Jain ,
Suresh Yadav Open the ORCID record for Suresh Yadav [Opens in a new window] ,
Sunil Kumar ,
Saji Oommen ,
Sapna Manocha  and
Genesh K. Jadav
Brijesh Goswami*
Affiliation:
Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India Department of Physics, Shobhit Institute of Engineering & Technology, Meerut, Uttar Pradesh, India
Rakesh Kumar Jain
Affiliation:
Department of Physics, Shobhit Institute of Engineering & Technology, Meerut, Uttar Pradesh, India
Suresh Yadav
Affiliation:
Department of Radiotherapy, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Sunil Kumar
Affiliation:
Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India
Saji Oommen
Affiliation:
Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India
Sapna Manocha
Affiliation:
Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India
Genesh K. Jadav
Affiliation:
Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India
*
Author for correspondence: Brijesh Goswami, Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi110076, India and Department of Physics, Shobhit Institute of Engineering & Technology, Modipuram, Meerut, Uttar Pradesh250110, India. E-mail: [email protected], [email protected]
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Abstract

Aim:

Comparison of the integral dose (ID) delivered to organs at risk (OAR), non-target body and target body by using different techniques of craniospinal irradiation (CSI).

Materials and methods:

Ten CSI patients (medulloblastoma) already planned and treated either with linear accelerator three-dimensional conformal radiation therapy (Linac-3DCRT) technique or with linear accelerator RapidArc (Linac-RapidArc) technique by Novalis-Tx Linac machine have been analysed. Retrospectively, these patients are again planned on Radixact-X9 Linac with Helical, Direct-3DCRT and Direct-intensity-modulated radiation therapy (Direct-IMRT) techniques. The dose prescription to planning target volume brain (PTV-Brain) and PTV-Spine is 36 Gy in 20 fractions and is kept the same for all techniques. The target body, non-target body, OARs and total body dose are compared.

Results:

ID is lowest in the RapidArc plan for every patient in comparison to Helical and Direct-IMRT. The ID for Body-PTV was found slightly higher in the RapidArc plan in comparison to 3DCRT plans. But there is better normal tissue sparing for most of the OARs in RapidArc plans if it compares with 3DCRT plans.

Findings:

RapidArc is a better alternative for the treatment of CSI. It provides better target coverage and better OARs sparing from any other treatment techniques.

Keywords

craniospinal irradiationhelicalintegral doseintensity-modulated radiotherapyRapidArcthree-dimensional conformal radiation therapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 345 - 350
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Brodin, N P, Munck, A F Rosenschöld, P et al. Radiobiological risk estimates of adverse events and secondary cancer for proton and photon radiation therapy of pediatric medulloblastoma. Acta Oncol 2011; 50: 806–816.CrossRefGoogle ScholarPubMed
Partap, S, Curran, E K, Propp, J M, Le, G M, Sainani, K L, Fisher, P G. Medulloblastoma incidence has not changed over time: a CBTRUS study. J Pediatr Hematol Oncol 2009; 31: 970–971.CrossRefGoogle Scholar
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: 4724.CrossRefGoogle ScholarPubMed
Peñagaricano, 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: 1155–1161.CrossRefGoogle ScholarPubMed
Gajjar, A, Hernan, R, Kocak, M et al. Clinical, histopathologic, and molecular markers of prognosis: toward a new disease risk stratification system for medulloblastoma. J Clin Oncol 2004; 15: 984–993.CrossRefGoogle Scholar
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: 4202–4208.CrossRefGoogle ScholarPubMed
Mah, K, Danjoux, E C, Manship, S, Makhani, N, Cardoso, M, Sixel, K E. Computed tomographic simulation of craniospinal fields in pediatric patients: improved treatment accuracy and patient comfort. Int J Radiat Oncol Biol Phys 1998; 41: 997–1003.CrossRefGoogle ScholarPubMed
Parker, W A, Freeman, C R. A simple technique for craniospinal radiotherapy in the supine position. Radiother Oncol 2006; 78: 217–222.CrossRefGoogle ScholarPubMed
Parker, W, Filion, E, Roberge, D, Freeman, C R. Intensity modulated radiotherapy for craniospinal irradiation: target volume considerations, dose constraints and competing risks. Int J Radiat Oncol Biol Phys 2007; 69: 251–257.CrossRefGoogle ScholarPubMed
Spirou, S V, Chui, C S. Generation of arbitrary intensity profiles by dynamic jaws or multileaf collimators. Med Phys 1994; 21: 1031–1041 CrossRefGoogle ScholarPubMed
Otto, K. Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys 2008; 35: 310–317.CrossRefGoogle Scholar
Peñagaricano, J A, Papanikolaou, N, Yan, Y, Youssef, E, Ratanatharathorn, V. Feasibility of cranio-spinal axis irradiation with the Hi-Art tomotherapy system. Radiother Oncol 2005; 76: 72–78.CrossRefGoogle ScholarPubMed
Bauman, G, Yartsev, S, Coad, T, Fisher, B, Kron, T. Helical tomotherapy for craniospinal radiation. Br J Radiol 2005; 78: 548–552.CrossRefGoogle ScholarPubMed
Patel, S, Warkentin, H, Powell, K, Syme, A, Warkentin, B, Fallone, G. Comparison of RapidArc volumentric modulated arc therapy, helical tomotherapy, and 3D conformal radiotherapy for pediatric craniospinal irradiation. Int J Radiat Oncol Biol Phys 2010; 78: S591.CrossRefGoogle Scholar
Lee, Y K, Brooks, C J, Bedford, J L, Warrington, A P, Saran, F H. Development and evaluation of multiple isocentric volumetric modulated arc therapy technique for craniospinal axis radio-therapy planning. Int J Radiat Oncol Biol Phys 2012; 82: 1006–1012.CrossRefGoogle Scholar
Hong, J Y, Kim, G W, Kim, C U et al. Supine linac treatment versus tomotherapy in craniospinal irradiation: planning comparison and dosimetric evaluation. Radiat Prot Dosimetry 2011; 146: 346–366.CrossRefGoogle ScholarPubMed
Parker, W, Brodeur, M, Roberge, D, Freeman, C. Standard and nonstandard craniospinal radiotherapy using helical tomotherapy. Int J Radiat Oncol Biol Phys 2010; 77: 926–931.CrossRefGoogle ScholarPubMed
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: 187–195.CrossRefGoogle ScholarPubMed
Kim, J, Jeong, K, Chung, Y et al. Feasibility of TomoDirect 3D-conformal radiotherapy for craniospinal irradiation. Int J Radiat Oncol 2010; 78: S828.CrossRefGoogle Scholar
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: 104–114.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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: 152–158.CrossRefGoogle ScholarPubMed
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: 488–491.CrossRefGoogle Scholar
Yadav, S, Singh, O P, Choudhary, S, Saroj, D K, Yogi, V, Goswami, B. Estimation and comparison of integral dose to target and organs at risk in three-dimensional computed tomography image-based treatment planning of carcinoma uterine cervix with two high-dose-rate brachytherapy sources: 60Co and 192Ir. J Can Res Ther [Epub ahead of print]. doi:10.4103/jcrt.JCRT_199_19.CrossRefGoogle Scholar
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.CrossRefGoogle ScholarPubMed