title: Supine linac treatment versus tomotherapy in craniospinal irradiation: planning comparison and dosimetric evaluation.
abstract: Craniospinal irradiation (CSI) is the standard treatment of primary intracranial tumour with risk of leptomeningeal dissemination. However, supine setup field-in-field technique does not need inter-fractional junction shift. Recently, the studies of CSI with tomotherapy showed excellent target coverage and tolerable normal organ dose in paediatric patients. The planning comparison and dosimetric difference between conventional radiotherapy and tomotherapy are presented. Three patients with central nervous system germinoma received supine CSI treatment. Normal tissue complication probability calculation was performed for parotid gland, kidney, lens, small bowel, ovary and testis. Homogenous vertebral body coverage for tomotherapy compared with conformal radiotherapy was found. The mean dose to each parotid gland decreased by 7.3 and 10 Gy, respectively, with tomotherapy. The volume of oesophagus and small bowel receiving >10 Gy was significantly lower. The V2, V5, V10 and V20 of the lungs are 81.6, 12.4, 2.3 and 0 % with tomotherapy. Tomotherapy showed excellent homogenous dose distribution through the craniospinal axis (PTV) and higher conformity index.
authors.affiliation: Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea, #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Hong
authors.forename: G W
authors.initials: GW
authors.lastname: Kim
authors.forename: C U
authors.initials: CU
authors.lastname: Kim
authors.forename: G S
authors.initials: GS
authors.lastname: Cheon
authors.forename: S H
authors.initials: SH
authors.lastname: Son
authors.forename: J Y
authors.initials: JY
authors.lastname: Lee
authors.forename: Y H
authors.initials: YH
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: B O
authors.initials: BO
authors.lastname: Choi
authors.forename: Y S
authors.initials: YS
authors.lastname: Kim
authors.forename: S N
authors.initials: SN
authors.lastname: Lee
authors.forename: H S
authors.initials: HS
authors.lastname: Jang
authors.forename: Y N
authors.initials: YN
authors.lastname: Kang
authors.forename: S C
authors.initials: SC
authors.lastname: Yoon
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D002648:Child; D016371:Cranial Irradiation; D005260:Female; D018237:Germinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D056888:Patient Positioning; D011829:Radiation Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated; D013125:Spinal Neoplasms / Q000532:radiotherapy*; D013131:Spine / Q000528:radiation effects*; D016683:Supine Position; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome