19 Harley St, London, W1G 9QJ, UK
We are London's Top Spine Clinic

Comparison of deliverable IMRT and VMAT for spine metastases using a simultaneous integrated boost.

Related Articles

Comparison of deliverable IMRT and VMAT for spine metastases using a simultaneous integrated boost.

Br J Radiol. 2013 Feb;86(1022):20120466

Authors: Lee YK, Bedford JL, McNair HA, Hawkins MA

OBJECTIVE: To effectively treat spine metastases, significant dose must be delivered to regions surrounding the spinal cord. We present a study comparing both step-and-shoot intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques to deliver a concomitant hypofractionated prescription dose to the diseased region and to the involved vertebrae.
METHODS: Seven-field IMRT and a single arc VMAT were inversely planned on five (two cervical and three thoracic) spinal metastatic patients. Planning target volumes PTVm (macroscopic) and PTVe (elective involved vertebrae) and associated organs at risk were localised. Mean doses of 35?Gy to PTVm and 20?Gy to PTVe were prescribed in five fractions. Dose statistics, estimated delivery time and results of verification using Delta(4) (ScandiDos, Uppsala, Sweden) were compared.
RESULTS: Deliverable plans were achieved with both IMRT and VMAT. The coverage to PTV was similar for both IMRT and VMAT (p=0.5) and the dose to the regions adjacent to the spinal cord was 1% higher with VMAT (p=0.04). The mean delivery time for VMAT was 3.5?min compared with 10.5?min for IMRT. Fewer monitor units were required to deliver IMRT than to deliver VMAT. The median (range) percentage of measured points with a ?-index <1 with 3%/3?mm was 100 (99.9-100)% for IMRT and 100 (88.5-100)% for VMAT.
CONCLUSION: Both VMAT and IMRT can deliver the concomitant hypofractionated regime proposed, and both offer different benefits in dose delivery. IMRT is currently preferred for its superior pre-treatment verification results and shorter planning times. ADVANCES IN KNOWLEDGE: This study explores the feasibility of delivering tumouricidal doses of radiation to metastatic spine disease in the vicinity of the spinal cord.

PMID: 23385999 [PubMed – indexed for MEDLINE]

Share to care...

Share on facebook
Share on twitter
Share on pinterest
Share on google
Share on linkedin
Share on skype

What we do...

The Harley Street Hospital


What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

We treat all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

What our patients say about us ......