A dosimetric comparison of craniospinal irradiation using TomoDirect radiotherapy, TomoHelical radiotherapy and 3D conventional radiotherapy

TSANG, Shirley W. S., COLLINS, Mark, WONG, Jacky T. L. and CHIU, George (2017). A dosimetric comparison of craniospinal irradiation using TomoDirect radiotherapy, TomoHelical radiotherapy and 3D conventional radiotherapy. Journal of Radiotherapy in Practice, 16 (4), 391-402.

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Abstract

Aim: The purpose of this study was to dosimetrically compare TomoDirect, TomoHelical and linear accelerator-based 3D-conformal radiotherapy (Linac-3DCRT) for craniospinal irradiation (CSI) in the treatment of medulloblastoma. Methods: Five CSI patients were replanned with Linac-3DCRT, TomoHelical, TomoDirect-3DCRT and TomoDirect-intensity-modulated radiotherapy (IMRT). Dose of 36 Gy in 20 fractions was prescribed to the planning target volume (PTV). Homogeneity index (HI), non-target integral dose (NTID), dose–volume histograms, organs-at-risk (OARs) D max, D mean and treatment times were compared. Results: TomoHelical achieved the best PTV homogeneity compared with Linac-3DCRT, TomoDirect-3DCRT and TomoDirect-IMRT (HI of 3·6 versus 20·9, 8·7 and 9·4%, respectively). TomoDirect-IMRT achieved the lowest NTID compared with TomoDirect-3DCRT, TomoHelical and Linac-3DCRT (141 J versus 151 J, 181 J and 250 J), indicating least biological damage to normal tissues. TomoHelical plans achieved the lowest D max in all organs except the breasts, and lowest D mean for most OARs, except in laterally situated OARs, where TomoDirect triumphed. Beam-on time was longest for TomoHelical, followed by TomoDirect and Linac-3DCRT. Findings: TomoDirect has the potential to lower NTID and shorten treatment times compared with TomoHelical. It reduces PTV inhomogeneity and better spares OARs compared with Linac-3DCRT. Therefore, TomoDirect may be a CSI treatment alternative to TomoHelical and in place of Linac-3DCRT.

Item Type:	Article
Uncontrolled Keywords:	3DCRT; craniospinal irradiation; TomoDirect; tomotherapy
Research Institute, Centre or Group - Does NOT include content added after October 2018:	Centre for Health and Social Care Research
Identification Number:	https://doi.org/10.1017/S1460396917000309
Page Range:	391-402
Depositing User:	Carmel House
Date Deposited:	08 Aug 2017 16:19
Last Modified:	18 Mar 2021 01:06
URI:	https://shura.shu.ac.uk/id/eprint/16434

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