Research Article

Dosimetric Comparison of Scalp Protection in Whole Brain Radiotherapy Due to Brain Metastasis

Volume: 7 Number: 2 June 25, 2020
  • Mehmet Demirtaş *

Dosimetric Comparison of Scalp Protection in Whole Brain Radiotherapy Due to Brain Metastasis

Abstract

Objective: The objective is to demonstrate dosimetrically the preservation of scalp in whole-brain irradiation in the treatment of brain metastases and to make dosimetry at 20 points determined on the rando phantom while comparing between Linac and Tomotherapy devices. In this way, if it is supported by clinical studies in the following years while giving more doses to the tumor, the damage to the traumatic functions due to hair loss can be prevented under scalp protection. Method: 10 randomized patients, who had previously undergone radiotherapy for whole-brain metastasis cancer, were determined prospectively. In Helical Tomotherapy (HT) and Linac devices, Intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) were planned to be 30 Gray (Gy) 10 Fractions for the whole brain region. Result: The average target volume (PTV) Homogeneity index (HI), conformity index (CI) and integral dose (ID) were found for IMRT and VMAT as 0.075, 0.77, 0.94, 0.97 and 29.67, 23.57, respectively. Mean and median doses for scalp IMRT and VMAT were 19.71Gy and 18.01 Gy (p<0.005). Lenses and body doses were statistically significant for IMRT and Vmat. The mean median plan doses for Rando phantom scalp were 19.43 Gy and 19.55 Gy in IMRT and VMAT, respectively. The mean median film doses for Rando phantom scalp were 17.03 Gy and 20.64 Gy in IMRT and VMAT, respectively (p<0.005). Conclusion: By using both VMAT and Helical Tomotherapy techniques, it is possible to dry the lens and scalp without low PTV doses in whole-brain irradiation.

Keywords

References

  1. 1. Achrol AS, Rennert RC, Anders C, Soffietti R, Ahluwalia MS, Nayak L, Peters S, Arvold ND, Harsh GR, Steeg PS, Chang SD. Brain metastases. Nat Rev Dis Primers. 2019 Jan 17;5(1):5
  2. 2. Zhi-zhen W, Zhi-yong Y, Wen-cheng Z, et al. Brain metastasis treated with Cyberknife, Chin Med J 2009; 122 (16): 1847-1850
  3. 3. Murai T, Ogino H, Manabe Y, et al. Fractionated stereotactic radiotherapy using Cyberknife for the treatment of large brain metastases: a dose-escalation study, ClinicalOncology 26 (2014) 151-158
  4. 4. Lippitz B, Lindquist C, Paddick I, et al. Stereotactic radiosurgery in the treatment of brain metastases: The current evidence, Cancer Treatment Reviews 40 (2014) 48-59
  5. 5. Sio TT, Jang S, Lee SW, et al. Comparing Gamma KnifeandCyberknife in patients with brain metastases, Journal of Applied Clinical Medical Physics, Vol. 15, No. 1, 2014
  6. 6. S. Scoccianti, G. Simontacchi, C. Talamonti, L.Marrazzo, G.A. Carta, L. Visani, M. Baki, L. Poggesi, D. Greto, B. Detti, P. Bonomo, M. Loi, S. Pallotta, L.Livi. Scalp-sparing radiotherapy to minimize alopecia in patients with primary brain cancer
  7. 7. Ahmad I, Sardana K, Chufal KS, Bhatt CP (2018) Radiation-Induced Alopecia: An Under-Appreciated Side Effect of Whole Brain Radiotherapy and Strategies to Ameliorate it J Nucl Med Radiat Ther S9: 002
  8. 8. Mehta MP, Tsao MN, Whelan TJ, et al. The American society for therapeutic radiology and oncology (ASTRO) evidence- based review of the role of radiosurgery for brain metastases, Int. J. Radiation Oncology Biol. Phys., Vol. 63, No. 1, pp. 37- 46, 2005

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Mehmet Demirtaş * This is me
Türkiye

Publication Date

June 25, 2020

Submission Date

March 28, 2020

Acceptance Date

May 22, 2020

Published in Issue

Year 2021 Volume: 7 Number: 2

Vancouver
1.Mehmet Demirtaş. Dosimetric Comparison of Scalp Protection in Whole Brain Radiotherapy Due to Brain Metastasis. ULUTAS MED J [Internet]. 2020 Jun. 1;7(2):69-76. Available from: https://izlik.org/JA48WD46DZ