Dosimetric Comparison of Craniospinal Axis Irradiation (CSI) Treatments Using Helical Tomotherapy, Smartarc.docVIP

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Dosimetric Comparison of Craniospinal Axis Irradiation (CSI) Treatments Using Helical Tomotherapy, Smartarc.doc

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Dosimetric Comparison of Craniospinal Axis Irradiation (CSI) Treatments Using Helical Tomotherapy, Smartarc

International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 2013, 2, 30-38 Published Online February 2013 (/journal/ijmpcero) /10.4236/ijmpcero.2013.21005 Dosimetric Comparison of Craniospinal Axis Irradiation (CSI) Treatments Using Helical Tomotherapy, SmartarcTM, and 3D Conventional Radiation Therapy* Pamela Myers, Sotirios Stathakis, Alonso N. Gutiérrez, Carlos Esquivel, Panayiotis Mavroidis, Niko Papanikolaou Departments of Radiology and Radiation Oncology, Cancer Therapy and Research Center, University of Texas Health Science Center, San Antonio, USA Email: Stathakis@ Received August 4, 2012; revised September 7, 2012; accepted September 15, 2012 ABSTRACT Purpose: Craniospinal axis irradiation (CSI) is a method of treating various central nervous system malignancies. The large target volume typically includes entire spinal cord and whole brain. Dosimetric comparison was performed be- tween tomotherapy, volumetric modulated arc therapy (VMAT), and 3D conformal radiation therapy (3D-CRT) for CSI. Methods and Materials: Five (n = 5) CSI patients were planned using 3D-CRT, VMAT, and tomotherapy (normalized such that 95% of PTV received at least 23.4 Gy in 13 fractions). Plans were compared using PTV conformity number (CN) and homogeneity index (HI), normal tissue (NT) dose statistics, integral dose, and treatment time. Results: On average, tomotherapy plans showed higher CN (0.932 vs. 0.860 and 0.672 for SmartArc and 3D-CRT). In terms of HI, VMAT plans consistently showed better dose homogeneity (1.07 vs. 1.15 and 1.13 for tomotherapy and 3D-CRT). SmartArc delivered lower maximum dose for majority of NT, but higher mean dose. 3D-CRT plans delivered higher maximum dose but lower mean dose to NT. Conclusions: SmartArc treatments achieved better PTV homogeneity and reduced maximum dose to NT. Tomotherapy showed better target conformity, but 3D-CRT was shown to reduce mean dose to NT. Integr