<title>Gamma knife, stereotactic linac radiosurgery, and micro multileaf collimator optimized treatment plan comparison</title>

Abstract

The aim of conformal radiation therapy and of radiosurgery (Gamma Knife and Multi-beam radiosurgery) is to irradiate the pathological target volume with ionizing radiation while avoiding as well as possible the surrounding normal tissues. Recently, new micro multileaf collimator ((mu) MLC) devices are available for conformal therapy. A (mu) MLC is formed by narrow sliding leafs in such a manner that the irradiation field can be adjusted to the shape of the target. It is interesting to compare the different techniques to evaluate their effectiveness and their accuracy. This comparison involves 8 clinical cases. For each treatment modality, we compare indexes defined in the international literature by the Radiation Therapy Oncology Group (RTOG). This theoretical study shows (i) the interest of the use of intensity modulation in the case of conformal radiation therapy and (ii) the improvement of RTOG indexes with using the conformal radiotherapy although the volumes of irradiated normal tissue remains lower with the radiosurgery than those with the (mu) MLC. However the comparison between these three techniques for the brain tumors shows that in complex cases it is more effective to use the fractionated conformal therapy with intensity modulation instead of radiosurgery. It is already sure that the micro multileaf collimator holds an important place in conformal therapy.