Dosimetric analysis of Tomotherapy-based intracranial stereotactic radiosurgery of brain metastasis.

Détails

ID Serval
serval:BIB_D86E9200FD67
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Dosimetric analysis of Tomotherapy-based intracranial stereotactic radiosurgery of brain metastasis.
Périodique
Physica medica
Auteur(s)
Agostinelli S., Garelli S., Gusinu M., Zeverino M., Cavagnetto F., Pupillo F., Bellini A., Taccini G.
ISSN
1724-191X (Electronic)
ISSN-L
1120-1797
Statut éditorial
Publié
Date de publication
08/2018
Peer-reviewed
Oui
Volume
52
Pages
48-55
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Résumé
This paper analyzes Tomotherapy-based intracranial stereotactic radiosurgery (HTSRS) of brain metastasis targeting two end-points: 1) evaluation of dose homogeneity, conformity and gradient scores for single and multiple lesions and 2) assay of dosimetric criticality of completion of HTSRS procedures.
42 treatment plans of 33 patients (53 brain lesions) treated with HTSRS were analyzed. Dose to healthy brain, homogeneity, conformity and gradient indexes were evaluated for each lesion. Influence of Field Length and multiple lesions cross-talk effect were assessed. Treatment interruption and completion was investigated using radiochromic films in order to examine the delivered dose and its robustness to patient intrafraction movement.
The average dose homogeneity index was 1.04 ± 0.02 (SD). Average dose conformity and gradient score indexes were 1.4 ± 0.2 and 50 ± 14 respectively. We found a strong correlation of the dose to healthy brain and conformity and gradient indexes with target(s) volume for which analytical functions were obtained. Field Length and cross-talk effect were significantly correlated with poor gradient scores, but were found not to affect dose conformity.
Homogeneity and conformity of HTSRS plans achieved excellent scores, while dose falloff and dose to healthy brain were slightly larger when compared with non-coplanar SRS techniques. Care should be given if treating large (>3 cc) or multiple near in-plane lesions in order to reduce dose to healthy brain. Analysis of interrupted treatments suggests splitting HTSRS treatments in two consecutive fractions in order to prevent target miss and overdosage due to patient intrafraction movement.
Mots-clé
Brain/radiation effects, Brain Neoplasms/radiotherapy, Brain Neoplasms/secondary, Film Dosimetry, Humans, Quality of Health Care, Radiosurgery/methods, Radiotherapy Dosage, Radiotherapy, Intensity-Modulated/methods, Brain radiosurgery, Conformity index, Dose gradient, Radionecrosis, Stereotactic treatment, Tomotherapy, Treatment interruption
Pubmed
Web of science
Création de la notice
04/09/2018 11:28
Dernière modification de la notice
20/08/2019 15:57
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