Iranian Journal of Medical Physics

Iranian Journal of Medical Physics

Dosimetric Comparative Study between Single and Dual Isocenter Stereotactic Body Radiotherapy Plans in Treatment of Multiple Lesions Non-Small Cell Lung Cancer Patients

Document Type : Original Paper

Authors
Mona Ibraheim 1
Magda Hanafy 1
Khaled El-Shahat 2
Mohammed Bayomy 3
Hany Attallah 4
Nesma salah khalil 5
1 Physics Department, Faculty of Science, Zagazig University, Zagazig, Egypt.
2 Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, El-Azhar University, Cairo, Egypt
3 Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, ZagazigUniversity, Zagazig, Egypt.
4 Radiation Oncology Department, International Medical Center (IMC), Egypt.
5 Clinical Oncology and Nuclear Medicine department, Zagazig University Hospitals, Egypt.
10.22038/ijmp.2022.57836.2064
Abstract
Introduction: stereotactic body radiotherapy (SBRT) is the most proper treatment for multi lesions non-small cell lung cancer (NSCLC) for enhanced good coverage and minimizing dose to organs at risk (OARs). This study aims to compare single and dual isocenter SBRT plans and discuss which technique we can use in multi lesions NSCLC.
Material and Methods: Ten patients with multi targets NSCLC underwent two different SBRT treatment planning techniques including single isocenter and dual isocenter. We quantitatively assessed plans qualities by dose-volume metrics. Conformity index (CI), Confirmation Number (CN), heterogeneity index (HI), gradient distance (GD), Gradient index (GI), and maximum percentage dose at 2cm all around PTV ( ) were gathered, tallied, and statistically examined. OARs were evaluated and the dose to the normal lung was evaluated using V5, V10, V20, and mean lung dose (MLD).
Results: There is an insignificant difference between single and dual isocenter plans in CI, CN, HI, GD, GI, and dose spillage where the mean distance between two lesions was 5.50 ± 1.50 cm, and the mean total volume of the planning target volume (PTV) was 42.60±21.33cc. For single and dual isocenter plans, the median MLD was 4.5(2-16)Gy and 4 (2-16)Gy respectively (p=0.25).
Conclusion: Plan quality of single isocenter was equal to dual isocenter for SBRT treatment of multi lung lesions with maximum distances between them was 10 cm.  Dual isocenter took time during setup and matching for cone beam computed tomography (CBCT).
Keywords
Stereotactic Body Radiotherapy
VMAT
Lung Cancer
Subjects
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Iranian Journal of Medical Physics
Volume 20, Issue 3
May and June 2023
Pages 146-152

  • Receive Date 11 January 2022
  • Revise Date 04 June 2022
  • Accept Date 11 June 2022