Dosimetric Comparison of Craniospinal Axis Irradiation (CSI) Treatments Using Helical Tomotherapy, SmartarcTM, and 3D Conventional Radiation Therapy

DOI: 10.4236/ijmpcero.2013.21005   PDF   HTML     6,031 Downloads   11,443 Views   Citations


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 between 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. Integral doses were similar between treatment modalities, but tomotherapy treatment times were much longer.

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P. Myers, S. Stathakis, A. Gutiérrez, C. Esquivel, P. Mavroidis and N. Papanikolaou, "Dosimetric Comparison of Craniospinal Axis Irradiation (CSI) Treatments Using Helical Tomotherapy, SmartarcTM, and 3D Conventional Radiation Therapy," International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, Vol. 2 No. 1, 2013, pp. 30-38. doi: 10.4236/ijmpcero.2013.21005.

Conflicts of Interest

The authors declare no conflicts of interest.


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