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Comparability of 4 strategies for backbone stereotactic physique radiotherapy: Dosimetric and effectivity evaluation.

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Comparability of 4 strategies for backbone stereotactic physique radiotherapy: Dosimetric and effectivity evaluation.

J Appl Clin Med Phys. 2018 Mar;19(2):160-167

Authors: Aljabab S, Vellayappan B, Vandervoort E, Bahm J, Zohr R, Sinclair J, Caudrelier JM, Szanto J, Malone S

Summary
PURPOSE: The goal of this examine is to check the dosimetric variations between 4 strategies for backbone stereotactic physique radiotherapy (SBRT): CyberKnife (CK), volumetric modulated arc remedy (VMAT), and helical tomotherapy (HT) with dynamic jaws (HT-D) and glued jaws (HT-F).
MATERIALS/METHODS: Information from 10 sufferers had been utilized. All sufferers had been deliberate for 24 Gy in two fractions, with the first aims being: (a) limiting the utmost dose to the wire to ? 17 Gy and/or cauda equina to ? 20 Gy, and (b) to maximise the medical goal quantity (CTV) to obtain the prescribed dose. Remedy plans had been generated by separate dosimetrists after which in contrast utilizing velocity AI. Parameters of comparability embrace goal quantity protection, conformity index (CI), gradient index (GI), homogeneity index (HI), remedy time (TT) per fraction, and monitor items (MU) per fraction.
RESULTS: PTV D2 and D5 had been considerably larger for CK in comparison with VMAT, HT-F, and HT-D (P < zero.001). The typical quantity of CTV receiving the prescription dose (CTV D95) was considerably much less for VMAT in comparison with CK, HT-F and HT-D (P = zero.036). CI improved for CK (zero.69), HT-F (zero.66), and HT-D (zero.67) in comparison with VMAT (zero.52) (P = zero.013). CK (41.86) had the biggest HI in comparison with VMAT (26.99), HT-F (20.69), and HT-D (21.17) (P < zero.001). GI was considerably much less for CK (three.96) in comparison with VMAT (6.76) (P = zero.001). Likewise, CK (62.four min, 14059 MU) had the longest remedy time and MU per fraction in comparison with VMAT (eight.5 min, 9764 MU), HT-F (13 min, 10822 MU), and HT-D (13.5 min, 11418 MU) (P < zero.001).
CONCLUSION: Each CK and HT plans achieved conformal goal protection whereas respecting wire tolerance. Dose heterogeneity was considerably bigger in CK. VMAT required the least remedy time and MU output, however had the least steep GI, CI, and goal protection.

PMID: 29417728 [PubMed – indexed for MEDLINE]

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