title: A novel supine isocentric approach for craniospinal irradiation and its clinical outcome.
abstract: OBJECTIVE
  To report a novel approach for craniospinal irradiation (CSI) using a supine isocentric technique.
  
  
  METHODS
  Patients were treated in the supine position using CT simulation. Half-beam-blocked lateral cranial fields and superior spinal fields have the same isocentre, and their beam divergences match. Tangential irradiation provides a non-divergent junction for the other two full-beam spinal fields. Shielding for cranial fields was generated, and dose distribution was calculated using a three-dimensional planning system. When sacral spinal fields were required, two lateral opposite fields were designed to protect the urogenital organs. All treatment portals were filmed once per week.
  
  
  RESULTS
  At a median follow-up of 49.8 months, 5 relapses and no cases of radiation myelitis developed in 26 consecutive patients. In the junctions of the brain-spine or spine-spine field, no failure occurred. Three failures occurred in the primary site alone, two in the spinal axis alone.
  
  
  CONCLUSIONS
  The results of our study have shown that our novel approach for CSI was not associated with increased failures at the field junction and deaths. In addition, no radiation myelitis, pneumonia, severe damage to the heart and gastrointestinal tract, and second cancers occurred in our study.
  
  
  CONCLUSIONS
  This new approach is an optimal alternative in cancer centre without tomotherapy because of its convenience for immobilization, repeatability, optimal dose distribution and satisfactory clinical outcome.
authors.affiliation: 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|2 Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Yi-Kan
authors.initials: YK
authors.lastname: Cheng
authors.affiliation: 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.|3 Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zeng
authors.affiliation: 4 Prenatal Diagnosis Centre, Guangdong Women and Children Hospital, Guangzhou, China.
authors.forename: Shu-Biao
authors.initials: SB
authors.lastname: Ye
authors.affiliation: 2 Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zheng
authors.affiliation: 5 Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 6 Department of Clinical Laboratory, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Sun
authors.affiliation: 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Jiang
authors.affiliation: 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Wen-Zhao
authors.initials: WZ
authors.lastname: Sun
authors.affiliation: 7 Department of Radiotherapy, Cancer Center, The First People's Hospital of Foshan City, Sun Yat-Sen University, Foshan, Guangdong, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Xu
authors.affiliation: 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D061888:Craniospinal Irradiation / Q000379:methods*; D004806:Ependymoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016683:Supine Position; D013724:Teratoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult