title: Shielding in whole brain irradiation in the multileaf collimator era: dosimetric evaluation of coverage using SFOP guidelines against in-house guidelines.
abstract: OBJECTIVE
  Compare the planning target volume (PTV) coverage in three different shielding techniques in cranial irradiation.
  
  
  METHODS
  Tertiary care center, prospective study.
  
  
  METHODS
  The whole brain and meninges were contoured in ten planning CT scans, and expanded by 5 mm for the PTV. Shielding was designed using the French Society of Pediatric Oncology (SFOP) guidelines (SFOP plan), in-house recommendation (with 1 cm margin from the orbital roof and sphenoid wing) on a igitally Reconstructed Radiograph (DRR) and a third plan was generated using a 3D conformal radiation technique (3DCRT). The coverage of the PTV was noted using the isodose covering 95% of the PTV(D95), minimum dose within the PTV(D min ), and maximum dose within the PTV(D max ). The location of PTV not covered by the 95% isodose curve was noted. The median dose and maximum dose (D max ) to both eyes and maximum dose D max for the lens were noted.
  
  
  METHODS
  General linear model method repeated the measure of analysis of variance test (ANOVA).
  
  
  RESULTS
  PTV coverage was significantly poorer in the SFOP and in-house plans as compared to 3DCRT plan (P=0.04). Median volume of PTV not covered by 95% isodose curve was 4.18 cc, 1.01 cc, and 0 cc in SFOP, in-house, and 3DCRT plan, respectively.
  
  
  CONCLUSIONS
  In the absence of volumetric planning techniques, SFOP guidelines lead to inadequate coverage and the in-house method is recommended.
authors.affiliation: Department of Radiotherapy and Regional Cancer Center, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012, India.
authors.forename: Vijay M
authors.initials: VM
authors.lastname: Patil
authors.forename: Arun S
authors.initials: AS
authors.lastname: Oinam
authors.forename: Santam
authors.initials: S
authors.lastname: Chakraborty
authors.forename: Sushmita
authors.initials: S
authors.lastname: Ghoshal
authors.forename: Suresh C
authors.initials: SC
authors.lastname: Sharma
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy*; D016371:Cranial Irradiation; D006801:Humans; D008495:Medical Oncology / Q000592:standards; D010372:Pediatrics / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D011835:Radiation Protection / Q000295:instrumentation*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal