Dosimetric Comparison of Three - Dimensional Conformal Radiation Therapy (3DCRT) and Posterior Partial Arc Volumetric Modulated Arc Therapy (VMAT) Plan for Craniospinal Irradiation

Document Type : Original Paper

Authors

1 Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India

2 Department of Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India

3 Department of Radiotherapy and Oncology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India. Manipal 576104

Abstract

Introduction: This study compares three dimensional conformal radiotherapy (3DCRT) and Posterior Partial Arc volumetric modulated arc therapy (VMAT) planning techniques for treating craniospinal irradiation.  Material and Methods: Ten patients with Medulloblastoma were retrospectively considered for the study and replanned using 3DCRT and posterior partial arc VMAT techniques using MONACO 5.11, treatment-planning system (TPS). The dose prescribed for the planning target volume (PTV) was 36Gy in 20 Fractions, followed by a boost dose to the brain volume. The parameters such as Tumour coverage, the organ at risk (OAR) doses, conformity index (CI), homogeneity index (HI), and total monitor units (MU) were calculated for both plans. Comparison of the two planning techniques done using paired sample t-test.
Results: PTV coverage in VMAT and 3DRT was 97.994±2.2533 and 94.041±2.24907, respectively. The mean CI in 3DCRT and VMAT was 1.3459±0.3279 and 1.1714±0.1238, respectively, and the mean HI in 3DCRT and VMAT was 1.1151±0.0247 and 1.0634±0.0198, respectively. OAR doses were comparable in 3DCRT and VMAT. The total MU in 3DCRT and VMAT were 198.12±8.9539 and 978.403±170.0104, respectively.
Conclusion: Posterior Partial Arc VMAT plans are superior to 3DCRT in target coverage, conformity index, and homogeneity index. The OAR doses in the two planning techniques were comparable whereas, the duration of treatment was higher in VMAT compared to the 3DCRT method. Additionally, low dose volumes are reduced in VMAT due to partial posterior arcs. Considering all the factors, it can be concluded from the study that Posterior Partial Arc VMAT plans are superior to 3DCRT.

Keywords

Main Subjects

References

  1. Sarkar B, Munshi A, Manikandan A, Roy S, Ganesh T, Mohanti BK, et al. A low gradient junction technique of craniospinal irradiation using volumetric-modulated arc therapy and its advantages over the conventional therapy. Cancer/Radiothérapie. 2018 Feb 1;22(1):62-72. Doi: 10.1016/j.canrad.2017.07.047.
  2. Myers P, Stathakis S, Gutiérrez AN, Esquivel C, Mavroidis P, Papanikolaou N. Dosimetric comparison of craniospinal axis irradiation (CSI) treatments using helical tomotherapy, Smartarc TM, and 3D conventional radiation therapy. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology. 2013 Feb 26;2(01):30. Doi: 10.4236/ijmpcero.2013.21005.
  3. Goswami B, Jain RK, Yadav S, Kumar S, Oommen S, Manocha S, et al. Dosimetric comparison of integral dose for different techniques of craniospinal irradiation. Journal of Radiotherapy in Practice. 2021 Sep;20(3):345-50. Doi: 10.1017/S1460396920000424.
  4. Gurjar OP, Arya R, Goyal H, Handa P, Bagdare P, Khan A, et al. Craniospinal Irradiation in Medulloblastoma using High Energy Medical Linear Accelerator: an Innovative Approach to Planning Technique. Journal of Biomedical Physics & Engineering. 2019 Apr;9(2):151. Doi: 10.31661/jbpe.v0i0.767.
  5. Ganesh T, Sarkar B, Munshi A, Mohanti B. SU‐F‐T‐429: craniospinal irradiation by VMAT technique: impact of FFF beam and high resolution MLC on plan quality. Medical Physics. 2016 Jun;43(6Part19):3561-. Doi: 10.1118/1.4956614.
  6. Verma R, Kumar Jain G, Chougule A. Evaluation of Dosimetric Parameters for Adolescent Craniospinal Irradiation. Int. J. Adv. Res. 2020; 8(8): 396– Doi: 10.21474/ijar01/11506.
  7. Fogliata A, Bergström S, Cafaro I, Clivio A, Cozzi L, Dipasquale G, et al. Cranio-spinal irradiation with volumetric modulated arc therapy: a multi-institutional treatment experience. Radiotherapy and Oncology. 2011 Apr 1;99(1):79-85. Doi: 10.1016/j.radonc.2011.01.023.
  8. Myers P, Stathakis S, Mavroidis P, Esquivel C, Papanikolaou N. Evaluation of localization errors for craniospinal axis irradiation delivery using volume modulated arc therapy and proposal of a technique to minimize such errors. Radiotherapy and Oncology. 2013 Jul 1;108(1):107-13. Doi: 10.1016/j.radonc.2013.05.026.
  9. Peterson JL, Vallow LA, Kim S, Casale HE, Tzou KS. A smart setup for craniospinal irradiation. Progress in Medical Physics. 2013 Dec 30;24(4):230-6. Doi: 10.14316/pmp.2013.24.4.230.
  10. Parker WA, Freeman CR. A simple technique for craniospinal radiotherapy in the supine position. Radiotherapy and oncology. 2006 Feb 1;78(2):217-22. Doi: 10.1016/j.radonc.2005.11.009.
  11. Lee YK, Brooks CJ, Bedford JL, Warrington AP, Saran FH. Development and evaluation of multiple isocentric volumetric modulated arc therapy technique for craniospinal axis radiotherapy planning. International Journal of Radiation Oncology* Biology* Physics. 2012 Feb 1;82(2):1006-12. Doi: 10.1016/j.ijrobp.2010.12.033.
  12. Neelakandan V, Christy SS, Mukherji A, Reddy KS. Craniospinal irradiation by rapid Arc® technique in supine position: A dosimetric and clinical analysis. Journal of Current Oncology. 2018 Jan 1;1(1):16. Doi: 10.4103/jco.jco_4_17.
  13. Nourreddine A, Benlemlih M, Maghous A, El Mejjaoui S, Kebdani T, Hassouni K, et al. A dosimetric comparison between three‑dimensional conformal radiation therapy and volumetric-modulated arc therapy for medulloblastoma craniospinal irradiation. Onkologia i Radioterapia. 2022 Jan 1;16(1).
  14. Sarkar B, Munshi A, Ganesh T, Manikandan A, Mohanti BK. Dosimetric comparison of short and full arc in spinal PTV in volumetric-modulated arc therapy-based craniospinal irradiation. Medical Dosimetry. 2020 Mar 1;45(1):1-6. Doi: 10.1016/j.meddos.2019.03.003.
  15. Kataria T, Sharma K, Subramani V, Karrthick KP, Bisht SS. Homogeneity Index: An objective tool for assessment of conformal radiation treatments. Journal of medical physics/Association of Medical Physicists of India. 2012 Oct;37(4):207. Doi: 10.4103/0971-6203.103606.
  16. Feuvret L, Noël G, Mazeron JJ, Bey P. Conformity index: a review. International Journal of Radiation Oncology* Biology* Physics. 2006 Feb 1;64(2):333-42. Doi: 10.1016/j.ijrobp.2005.09.028.
  17. [Pollul G, Bostel T, Grossmann S, Akbaba S, Karle H, Stockinger M, et al. Pediatric craniospinal irradiation with a short partial-arc VMAT technique for medulloblastoma tumors in dosimetric comparison. Radiation Oncology. 2020 Dec;15(1):1-0. Doi: 10.1186/s13014-020-01690-5.
  18. Studenski MT, Shen X, Yu Y, Xiao Y, Shi W, Biswas T, et al. Intensity-modulated radiation therapy and volumetric-modulated arc therapy for adult craniospinal irradiation—A comparison with traditional techniques. Medical Dosimetry. 2013 Mar 1;38(1):48-54. Doi: 10.1016/j.meddos.2012.05.006.
  19. Chen J, Chen C, Atwood TF, Gibbs IC, Soltys SG, Fasola C, Xing L. Volumetric modulated arc therapy planning method for supine craniospinal irradiation. Journal of Radiation Oncology. 2012 Sep;1:291-7. Doi: 10.1007/s13566-012-0028-9.
  20. Sun Y, Liu G, Chen W, Chen T, Liu P, Zeng Q, et al. Dosimetric comparisons of craniospinal axis irradiation using helical tomotherapy, volume-modulated arc therapy and intensity-modulated radiotherapy for medulloblastoma. Translational Cancer Research. 2019 Feb;8(1):191. Doi: 10.21037/tcr.2019.01.30.
  21. Seravalli E, Bosman M, Lassen-Ramshad Y, Vestergaard A, Oldenburger F, Visser J, et al. Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers: analysis on behalf of the SIOP-E-BTG (radiotherapy working group). Acta Oncologica. 2018 Sep 2;57(9):1240-9. Doi: 10.1080/0284186X.2018.1465588.
  22. Sharma DS, Gupta T, Jalali R, Master Z, Phurailatpam RD, Sarin R. High-precision radiotherapy for craniospinal irradiation: evaluation of three-dimensional conformal radiotherapy, intensity-modulated radiation therapy and helical TomoTherapy. The British journal of radiology. 2009 Dec;82(984):1000-9. Doi: 10.1259/bjr/13776022.
  23. Herdian F, Lestari A, Sagung AA, Jayalie VF, Wibowo WE, Djakaria M, et al. Analysis of dosimetric parameter on craniospinal irradiation with Helical Tomotherapy (HT), 3D Conformal Radiotherapy (3DCRT), and Intensity Modulated Radiotherapy (IMRT). Onkologia i Radioterapia. 2020 Oct 1(4).
  24. Wang Z. Craniospinal IMRT. 2013. Available from: https://ro-journal.biomedcentral.com/track/pdf/10.1186/1748-717X-8-217?site=ro-journal.biomedcentral.com.

 

 

 

 

 

 

 

Iranian Journal of Medical Physics
Volume 20, Issue 6 - Serial Number 6
November and December 2023
Pages 372-379

Files

History

  • Receive Date: 05 December 2022
  • Revise Date: 30 January 2023
  • Accept Date: 06 February 2023

Share

How to cite

Statistics