open access

Vol 20, No 2 (2015)
Original research articles
Published online: 2015-03-01
Submitted: 2014-06-01
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Prospective study on dosimetric comparison of helical tomotherapy and 3DCRT for craniospinal irradiation – A single institution experience

Anna Bandurska-Luque, Tomasz Piotrowski, Agnieszka Skrobała, Adam Ryczkowski, Krystyna Adamska, Joanna Kaźmierska
DOI: 10.1016/j.rpor.2014.12.002
·
Rep Pract Oncol Radiother 2015;20(2):145-152.

open access

Vol 20, No 2 (2015)
Original research articles
Published online: 2015-03-01
Submitted: 2014-06-01

Abstract

Aim

This prospective study aims to assess feasibility of helical tomotherapy (HT) for craniospinal irradiation (CSI) and perform dosimetric comparison of treatment plans for both HT and 3D conformal radiotherapy (3DCRT).

Background

CSI is a challenging procedure. Large PTV size requires field matching due to technical limitations of standard linear accelerators, which cannot irradiate such volumes as a single field. HT could help to avoid these limitations as irradiation of long fields is possible without field matching.

Materials and methods

Three adults were enrolled from 2009 to 2010. All patients received radiochemotherapy. Treatment plans in prone position for 3DCRT and in supine position for HT were generated. The superior plan was used for patients’ irradiation. Plans were compared with the application of DVH, Dx parameters – where x represents a percentage of the structure volume receiving a normalized dose and homogeneity index (HI).

Results

All patients received HT irradiation. The treatment was well tolerated. The HT plans resulted in a better dose coverage and uniformity in the PTV: HI were 5.4, 7.8, 6.8 for HT vs. 10.3, 6.6, 10.4 for 3DCRT. For most organs at risk (OARs), the D(V80) was higher for HT than for 3DCRT, whereas D(V5) was lower for HT.

Conclusions

HT is feasible for CSI, and in comparison with 3DCRT it improves PTV coverage. HT reduces high dose volumes of OARs, but larger volumes of normal tissue receive low radiation dose. HT requires further study to establish correlations between dosimetrical findings and clinical outcomes, especially with regard to late sequelae of treatment.

Abstract

Aim

This prospective study aims to assess feasibility of helical tomotherapy (HT) for craniospinal irradiation (CSI) and perform dosimetric comparison of treatment plans for both HT and 3D conformal radiotherapy (3DCRT).

Background

CSI is a challenging procedure. Large PTV size requires field matching due to technical limitations of standard linear accelerators, which cannot irradiate such volumes as a single field. HT could help to avoid these limitations as irradiation of long fields is possible without field matching.

Materials and methods

Three adults were enrolled from 2009 to 2010. All patients received radiochemotherapy. Treatment plans in prone position for 3DCRT and in supine position for HT were generated. The superior plan was used for patients’ irradiation. Plans were compared with the application of DVH, Dx parameters – where x represents a percentage of the structure volume receiving a normalized dose and homogeneity index (HI).

Results

All patients received HT irradiation. The treatment was well tolerated. The HT plans resulted in a better dose coverage and uniformity in the PTV: HI were 5.4, 7.8, 6.8 for HT vs. 10.3, 6.6, 10.4 for 3DCRT. For most organs at risk (OARs), the D(V80) was higher for HT than for 3DCRT, whereas D(V5) was lower for HT.

Conclusions

HT is feasible for CSI, and in comparison with 3DCRT it improves PTV coverage. HT reduces high dose volumes of OARs, but larger volumes of normal tissue receive low radiation dose. HT requires further study to establish correlations between dosimetrical findings and clinical outcomes, especially with regard to late sequelae of treatment.

Get Citation

Keywords

Craniospinal irradiation; Helical tomotherapy; Dosimetric comparison

About this article
Title

Prospective study on dosimetric comparison of helical tomotherapy and 3DCRT for craniospinal irradiation – A single institution experience

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 20, No 2 (2015)

Pages

145-152

Published online

2015-03-01

DOI

10.1016/j.rpor.2014.12.002

Bibliographic record

Rep Pract Oncol Radiother 2015;20(2):145-152.

Keywords

Craniospinal irradiation
Helical tomotherapy
Dosimetric comparison

Authors

Anna Bandurska-Luque
Tomasz Piotrowski
Agnieszka Skrobała
Adam Ryczkowski
Krystyna Adamska
Joanna Kaźmierska

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