Tom 6, Nr 6 (2021)
Praca badawcza (oryginalna)
Opublikowany online: 2021-10-15

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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Static-junction craniospinal irradiation: verification of daily dose and long-term treatment results

Aleksandra Napieralska1, Michał Radwan2, Iwona Brąclik2, Sławomir Blamek1
Biuletyn Polskiego Towarzystwa Onkologicznego Nowotwory 2021;6(6):436-440.


Introduction. The study was performed to evaluate the repeatability and effectiveness of the static-junctions image guided (SJIG) method of craniospinal irradiation.

Material and methods. An analysis of 40 treatment plans was performed. All treatment plans were reviewed with regard to the distances between isocentres between in every single field of each fraction during all treatment days. Based on that data, second (actually treated) plans were created. The planned and treated parameters were compared.

Results. The study group consisted of 40 patients irradiated in the craniospinal region. Data on 902 fractions and 1635 isocentres positions was collected. 1-, 2- and 5-year overall survival was 95%, 89% and 78%, respectively. Spine metastases were observed in regions which were covered with a homogenous dose during treatment.

Conclusions. SJIG is safe and produces very good long-term outcomes. Treatment planning and delivery is simple with good reproduction of the planned dose distribution during the actual treatment.

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  1. Athiyaman H, Mayilvaganan A, Singh D. A simple planning technique of craniospinal irradiation in the eclipse treatment planning system. J Med Phys. 2014; 39(4): 251–258.
  2. Jenkin D. The radiation treatment of medulloblastoma. J Neurooncol. 1996; 29(1): 45–54.
  3. Wang Z, Jiang W, Feng Y, et al. A simple approach of three-isocenter IMRT planning for craniospinal irradiation. Radiat Oncol. 2013; 8: 217.
  4. Zong-Wen S, Shuang-Yan Y, Feng-Lei Du, et al. Radiotherapy for Adult Medulloblastoma: Evaluation of Helical Tomotherapy, Volumetric Intensity Modulated Arc Therapy, and Three-Dimensional Conformal Radiotherapy and the Results of Helical Tomotherapy Therapy. Biomed Res Int. 2018; 2018: 9153496.
  5. Wang K, Meng H, Chen J, et al. Plan quality and robustness in field junction region for craniospinal irradiation with VMAT. Phys Med. 2018; 48: 21–26.
  6. Seravalli E, Bosman M, Lassen-Ramshad Y, et al. Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers: analysis on behalf of the SIOP-E-BTG (radiotherapy working group). Acta Oncol. 2018; 57(9): 1240–1249.
  7. Sarkar B, Munshi A, Manikandan A, et al. A low gradient junction technique of craniospinal irradiation using volumetric-modulated arc therapy and its advantages over the conventional therapy. Cancer Radiother. 2018; 22(1): 62–72.
  8. Studenski MT, Shen X, Yu Y, et al. Intensity-modulated radiation therapy and volumetric-modulated arc therapy for adult craniospinal irradiation--a comparison with traditional techniques. Med Dosim. 2013; 38(1): 48–54.
  9. Ahmed SK, Kruse JJ, Bradley TB, et al. Clinical efficacy and safety of a highly conformal, supine, hybrid forward and inverse planned intensity modulated radiation therapy technique for craniospinal irradiation. Acta Oncol. 2018; 57(5): 629–636.
  10. Srivastava R, Saini G, Sharma PK, 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.
  11. Bandurska-Luque A, Piotrowski T, Skrobała A, et al. Prospective study on dosimetric comparison of helical tomotherapy and 3DCRT for craniospinal irradiation - A single institution experience. Rep Pract Oncol Radiother. 2015; 20(2): 145–152.
  12. Myers PA, Mavroidis P, Papanikolaou N, et al. Comparing conformal, arc radiotherapy and helical tomotherapy in craniospinal irradiation planning. J Appl Clin Med Phys. 2014; 15(5): 4724.
  13. Parker WA, Freeman CR. A simple technique for craniospinal radiotherapy in the supine position. Radiother Oncol. 2006; 78(2): 217–222.
  14. Hadley A, Ding GX. A single-gradient junction technique to replace multiple-junction shifts for craniospinal irradiation treatment. Med Dosim. 2014; 39(4): 314–319.
  15. Cao F, Ramaseshan R, Corns R, et al. A three-isocenter jagged-junction IMRT approach for craniospinal irradiation without beam edge matching for field junctions. Int J Radiat Oncol Biol Phys. 2012; 84(3): 648–654.
  16. Stoker JB, Grant J, Zhu XR, et al. Intensity modulated proton therapy for craniospinal irradiation: organ-at-risk exposure and a low-gradient junctioning technique. Int J Radiat Oncol Biol Phys. 2014; 90(3): 637–644.
  17. Parker W, Filion E, Roberge D, et al. Intensity-modulated radiotherapy for craniospinal irradiation: target volume considerations, dose constraints, and competing risks. Int J Radiat Oncol Biol Phys. 2007; 69(1): 251–257.
  18. Kusters JM, Louwe RJW, van Kollenburg PGM, et al. Optimal normal tissue sparing in craniospinal axis irradiation using IMRT with daily intrafractionally modulated junction(s). Int J Radiat Oncol Biol Phys. 2011; 81(5): 1405–1414.
  19. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995; 31(5): 1341–1346.
  20. Mah K, Danjoux CE, Manship S, et al. Computed tomographic simulation of craniospinal fields in pediatric patients: improved treatment accuracy and patient comfort. Int J Radiat Oncol Biol Phys. 1998; 41(5): 997–1003.
  21. Phillips C, Willis D, Cramb J, et al. A modified technique for craniospinal irradiation in children designed to reduce acute and late radiation toxicity. Australas Radiol. 2004; 48(2): 188–194.
  22. South M, Chiu JK, Teh BS, et al. Supine craniospinal irradiation using intrafractional junction shifts and field-in-field dose shaping: early experience at Methodist Hospital. Int J Radiat Oncol Biol Phys. 2008; 71(2): 477–483.
  23. Hawkins RB. A simple method of radiation treatment of craniospinal fields with patient supine. Int J Radiat Oncol Biol Phys. 2001; 49(1): 261–264.
  24. Christ G, Denninger D, Dohm OS, et al. Craniospinal radiotherapy in an advanced technique. Strahlenther Onkol. 2008; 184(10): 530–535.
  25. Strojnik A, Méndez I, Peterlin P. Reducing the dosimetric impact of positional errors in field junctions for craniospinal irradiation using VMAT. Rep Pract Oncol Radiother. 2016; 21(3): 232–239.
  26. Sharma DS, Gupta T, Jalali R, et al. 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.
  27. Lee YK, Brooks CJ, Bedford JL, et al. Development and evaluation of multiple isocentric volumetric modulated arc therapy technique for craniospinal axis radiotherapy planning. Int J Radiat Oncol Biol Phys. 2012; 82(2): 1006–1012.
  28. Grover S, Gudi S, Gandhi AK, et al. Radiation Oncology in India: Challenges and Opportunities. Semin Radiat Oncol. 2017; 27(2): 158–163.
  29. Barton MB, Zubizarreta EH, Polo Rubio JA. Radiotherapy in small countries. Cancer Epidemiol. 2017; 50(Pt B): 257–259.
  30. Zubizarreta EH, Fidarova E, Healy B, et al. Need for radiotherapy in low and middle income countries – the silent crisis continues. Clin Oncol (R Coll Radiol). 2015; 27(2): 107–114.
  31. Zubizarreta E, Van Dyk J, Lievens Y. Analysis of Global Radiotherapy Needs and Costs by Geographic Region and Income Level. Clin Oncol (R Coll Radiol). 2017; 29(2): 84–92.
  32. Donkor A, Luckett T, Aranda S, et al. Barriers and facilitators to implementation of cancer treatment and palliative care strategies in low- and middle-income countries: systematic review. Int J Public Health. 2018; 63(9): 1047–1057.
  33. Van Schelt J, Smith DL, Fong N, et al. A ring-based compensator IMRT system optimized for low- and middle-income countries: Design and treatment planning study. Med Phys. 2018; 45(7): 3275–3286.
  34. Holmes JA, Chera BS, Brenner DJ, et al. Estimating the excess lifetime risk of radiation induced secondary malignancy (SMN) in pediatric patients treated with craniospinal irradiation (CSI): Conventional radiation therapy versus helical intensity modulated radiation therapy. Pract Radiat Oncol. 2017; 7(1): 35–41.

Biuletyn Polskiego Towarzystwa Onkologicznego Nowotwory