Abstract
PurposeTo develop a new IMRT technique to simplify the process and improve efficiency in radiotherapy treatment planning for craniospinal irradiation (CSI) treatment.MethodsImage data of 9 patients who received CSI treatment in 2012 were used, the prescription was 36Gy in 20 fractions. Two treatment plans were created for each patient, one was with the new technique called three-isocenter overlap-junction (TIOJ) IMRT and the other was with the three-isocenter jagged-junction (TIJJ) IMRT technique. The comparative study was conducted using the parameters of heterogeneity index (HI), conformity index (CI), and doses to the organs at risk (OARs).ResultsComparing the TIOJ IMRT plans with the TIJJ IMRT plans, the average homogeneity index is 0.071 ± 0.003 and 0.077 ± 0.002, respectively, and the averaged conformity number is 0.80 ± 0.012 and 0.80 ± 0.009, respectively. There are no significant differences (p > 0.05). Both plans provide satisfactory sparing for the OARs.ConclusionsThe TIOJ IMRT technique for CSI treatment planning can create similar plans as with the TIJJ IMRT technique, but the new technique greatly simplifies the steps required to manually set field widths and boundaries and improved efficiency.
Highlights
Craniospinal irradiation (CSI) has become an important treatment method for primary tumors
For the nine patients included in this study, both three-isocenter overlap-junction (TIOJ) and three-isocenter jagged-junction (TIJJ) intensity modulated radiation therapy (IMRT) reach the goal of the 95% isodose curve covering at least 99% of the planning target volume (PTV)
homogeneity index (HI) and comformity Index (CI) obtained with TIOJ are 0.071 ± 0.003 (Mean ± variance) and 0.80 ± 0.012, respectively
Summary
Craniospinal irradiation (CSI) has become an important treatment method for primary tumors. Treated tumors include medulloblastoma, high-risk germcell tumors, and some radio-sensitive secondary malignant tumors of the meninges. Emerging radiotherapy techniques, such as three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiation therapy (IMRT), have gradually replaced the traditional large field radiotherapy technology used in CSI treatment. CSI involves complex anatomical structures and requires complex treatment planning, which often entails setting multiple isocenters and matching a large number of fields to obtain satisfactory plans. IMRT technology can offer better comformity Index (CI) and homogeneity index (HI) than traditional multi-field 3DCRT in complex target areas. Inverse treatment planning with IMRT reduces the difficulty of planning
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