Dosimetric advantages of O-ring design radiotherapy system for skull-base tumors.
The purpose of this study was to investigate whether a new O-ring design radiotherapy delivery system has advantages in radiotherapy planning for skull-base tumors. Twenty-five patients with skull-base tumors were included in this study. Two plans were made using conventional (Plan A) or new (Plan B) techniques. Plan A consisted of four dynamic conformal arcs (DCAs): two were horizontal, and the other two were from cranial directions. Plan B was created by converting horizontal arcs to those from caudal directions making use of the O-ring design radiotherapy system. The micromultileaf collimators were fitted to cover at least 99% of the planning target volume with prescribed doses, 90% of the dose at the isocenter. The two plans were compared in terms of target homogeneity, conformity, and irradiated volume of normal tissues, using a two-sided paired t-test. For evaluation regarding target coverage, the homogeneity indices defined by the International Commission on Radiation Units and Measurements 83 were 0.099 ± 0.010 (mean ± standard deviation) and 0.092 ± 0.010, the conformity indices defined by the Radiation Therapy Oncology Group were 1.720 ± 0.249 and 1.675 ± 0.239, and the Paddick's conformity indices were 0.585 ± 0.078 and 0.602 ± 0.080, in Plans A and B, respectively. For evaluation of irradiated normal tissue, the Paddick's gradient indices were 3.118 ± 0.283 and 2.938 ± 0.263 in Plans A and B, respectively. All of these differences were statistically significant (p-values < 0.05). The mean doses of optic nerves, eyes, brainstem, and hippocampi were also significantly lower in Plan B. The DCA technique from caudal directions using the new O-ring design radiotherapy system can improve target homogeneity and conformity compared with conventional DCA techniques, and can also decrease the volume of surrounding normal tissues that receives moderate doses.
Graduate School of Medicine Kyoto University. oguken@kuhp.kyoto-u.ac.jp.
Kengo
K
Ogura
Takashi
T
Mizowaki
Yuichi
Y
Ishida
Masahiro
M
Hiraoka
D000465:Algorithms; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D003397:Craniopharyngioma / Q000532:radiotherapy; D019583:Dose Fractionation, Radiation; D006801:Humans; D008579:Meningioma / Q000532:radiotherapy; D010911:Pituitary Neoplasms / Q000532:radiotherapy; D011859:Radiography; D011874:Radiometry / Q000379:methods*; D016634:Radiosurgery / Q000379:methods*; D011878:Radiotherapy / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012888:Skull Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012984:Software