Abstract
Background and PurposeThe treatment options available in the management of brain metastases includes fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS) treatments. FSRT treatments have proved to be useful mainly in the treatment of larger volumes. This study aims to evaluate the FSRT treatment technique used in our department based on various plan quality indices.Methods and Materials24 treatment plans of 23 patients were analyzed. Volumetric modulated arc therapy (VMAT) plans were generated in line with the department protocol. The following parameters were extracted: Radiation Therapy Oncology Group conformity index (RTOG CI), Paddick conformity index (Paddick CI), gradient index (GI), quality index (Q), homogeneity index (HI), and V24.4 volume as a parallel index of V12 used at SRS plan evaluation.ResultsPlan conformity was acceptable, RTOG CI mean was 0.942; Paddick CI mean was 0.824. The mean GI value was 6.146. The mean of HI and Q indices were 1.263 and 0.94, respectively. V24.4 mean was 33.434 cm3. All plans achieved clinically acceptable organs-at-risk (OAR) constraints. PTV volumes were clustered into either 10 cm3 or 15 cm3 bins depending on the plan quality metric we used. The mean values show a balanced distribution of plan indices along the various PTV bins.DiscussionOur results based on the derived indices show that our FSRT approach can achieve clinically acceptable treatment plans. Furthermore, the clustering of PTV volumes show that these plan quality metrics remain acceptable for a wide spectrum of PTV volumes.
Highlights
Brain metastases (BM) are considered to be a serious problem in the course of oncological diseases as 20-40% of patients affected by cancer will develop BMs [1]
Stereotactic radiosurgery (SRS) is the gold standard treatment of brain metastases (BM); there is a limitation in treatable tumour size (
The overall findings of our study have demonstrated the plausibility of using our fractionated stereotactic radiotherapy (FSRT) treatment technique in the treatment of multiple brain metastases
Summary
Brain metastases (BM) are considered to be a serious problem in the course of oncological diseases as 20-40% of patients affected by cancer will develop BMs [1]. The major treatment option for these patients was whole brain radiotherapy (WBRT), but today the treatment for BMs depends on the number and size of lesions, on the patients performance state and the oncological status of the primary disease [3, 4]. The aim of FSRT is to minimize the normal tissue toxicity while preserving local control. It lacks the precision of SRS with the head frame, but can decrease the margins; in addition to decreasing normal tissue dose, it makes use of the advantage of fractionation. The treatment options available in the management of brain metastases includes fractionated stereotactic radiotherapy (FSRT) and stereotactic radiosurgery (SRS) treatments. This study aims to evaluate the FSRT treatment technique used in our department based on various plan quality indices
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
