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

Yıl 2021, Cilt: 7 Sayı: 2, 69 - 76, 25.06.2020

Öz

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.

Kaynakça

  • 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. 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. 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. 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. 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. 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. 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. 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
  • 9. Gaspar LE, Mehta MP, Patchell RA, et al. The role of whole-brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline, J Neurooncol (2010) 96: 17-32
  • 10. Hunter GK, Suh JH, Reuther AM, et al. Treatment of five or more brain metastases with radiosurgery, Int. J. RadiationOncologyBiol. Phys.,Vol. 83, No. 5, pp. 1394-1398, 2012
  • 11. Webpages:https://www.qarc.org/cog/ACNS1721_Contouring Guidelines_20190306.pdf
  • 12. 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 MedicalPhysicists of India. 2012;37(4):207-213.
  • 13. Feuvret Liocet al., Conformity Index: a review, Int J RadiatOncolBiolPhys, 64(2), 2006, 333-342
  • 14. Aoyama H, Westerly DC, Mackie TR, Olivera GH, Bentzen SM, Patel RR. Integral radiation dose to normal structures with conformal external beam radiation. Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):962-7
  • 15. Roberge, D., Parker, W., Niazi, T. M., Olivares, M. Treating the contents and not the container: dosimetric study of hair- sparing whole brain intensity modulated radiation therapy. Technol Cancer Res Treat 4, 567-570
  • 16. Lawenda, B. D., Gagne, H. M., Gierga, D. P., Niemierko, A., Wong, W. M., Tarbell, N. J., Chen, G. T., Hochberg, F. H., Loeffler, J. S. Permanent alopecia after cranial irradiation: dose-response relationship. Int J Radiat Oncol Biol Phys 60, 879-887 (2004)
  • 17. Kao J, Darakchiev B, Conboy L, et al. Tumor Directed, Scalp Sparing Intensity Modulated Whole Brain Radiotherapy for Brain Metastases. Technology in Cancer Research & Treatment. October 2015:547-555
  • 18. Witek M, Vahknenko Y, Siglin J, Harrison A, Xiao Y, Lui H, Andrews D, Shi W. Dose Reduction to the Scalp with Hippocampal Sparing Is Achievable with Intensity Modulated Radiotherapy. Int J Med Phys Clin Eng Radiat Oncol. 2014 Aug;3(3):176-182
  • 19. Teoh M, Clark C.H, Wood K, Whitaker S, Nisbet A. Volumetric modulated arc therapy: a review of current literature and clinical use in practice. The British Journal of Radiology, 84 (2011), 967–996
  • 20.Williams N, Boyle F, Hong A, et al. Whole brain radiotherapy with partial hair-sparing technique - a feasibility study. Int J Radiol Radiat Ther. 2020;7(4):104-110
  • 21. Hu, YA, et al. How Well Do We Spare Scalp with Image- Guided Rotational IMRT. International Journal of Radiation Oncology, Biology, Physics, 2011; Volume 81, Issue 2, S840
  • 22.Yetmen Dogan O, Cini N, Nasır Can SS. Dosimetric comparison of volumetric modulated arc therapy (VMAT) and Helical tomotherapy for hippocampal avoidance prophylactic whole-brain radiotherapy (HA-PWBRT) in small cell lung cancer: Treatment plans based study. Med J Bakirkoy 2020;16(3):263-71
  • 23.Rong Y, Evans J, Xu-Welliver M, et al. Dosimetric evaluation of intensity-modulated radiotherapy, volumetric modulated arc therapy, and helical tomotherapy for hippocampal- whole brain Radiotherapy. PLoS One. 015;10(4):e0126222
  • 24.Krayenbuehl J, Di Martino M, Guckenberger M, Andratschke N. Improved plan quality with automated radiotherapy planning for whole brain with hippocampus sparing: a arison to the RTOG 0933 trial. Radiat Oncol. 2017 Oct 2;12(1):161
Yıl 2021, Cilt: 7 Sayı: 2, 69 - 76, 25.06.2020

Öz

Kaynakça

  • 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. 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. 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. 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. 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. 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. 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. 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
  • 9. Gaspar LE, Mehta MP, Patchell RA, et al. The role of whole-brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline, J Neurooncol (2010) 96: 17-32
  • 10. Hunter GK, Suh JH, Reuther AM, et al. Treatment of five or more brain metastases with radiosurgery, Int. J. RadiationOncologyBiol. Phys.,Vol. 83, No. 5, pp. 1394-1398, 2012
  • 11. Webpages:https://www.qarc.org/cog/ACNS1721_Contouring Guidelines_20190306.pdf
  • 12. 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 MedicalPhysicists of India. 2012;37(4):207-213.
  • 13. Feuvret Liocet al., Conformity Index: a review, Int J RadiatOncolBiolPhys, 64(2), 2006, 333-342
  • 14. Aoyama H, Westerly DC, Mackie TR, Olivera GH, Bentzen SM, Patel RR. Integral radiation dose to normal structures with conformal external beam radiation. Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):962-7
  • 15. Roberge, D., Parker, W., Niazi, T. M., Olivares, M. Treating the contents and not the container: dosimetric study of hair- sparing whole brain intensity modulated radiation therapy. Technol Cancer Res Treat 4, 567-570
  • 16. Lawenda, B. D., Gagne, H. M., Gierga, D. P., Niemierko, A., Wong, W. M., Tarbell, N. J., Chen, G. T., Hochberg, F. H., Loeffler, J. S. Permanent alopecia after cranial irradiation: dose-response relationship. Int J Radiat Oncol Biol Phys 60, 879-887 (2004)
  • 17. Kao J, Darakchiev B, Conboy L, et al. Tumor Directed, Scalp Sparing Intensity Modulated Whole Brain Radiotherapy for Brain Metastases. Technology in Cancer Research & Treatment. October 2015:547-555
  • 18. Witek M, Vahknenko Y, Siglin J, Harrison A, Xiao Y, Lui H, Andrews D, Shi W. Dose Reduction to the Scalp with Hippocampal Sparing Is Achievable with Intensity Modulated Radiotherapy. Int J Med Phys Clin Eng Radiat Oncol. 2014 Aug;3(3):176-182
  • 19. Teoh M, Clark C.H, Wood K, Whitaker S, Nisbet A. Volumetric modulated arc therapy: a review of current literature and clinical use in practice. The British Journal of Radiology, 84 (2011), 967–996
  • 20.Williams N, Boyle F, Hong A, et al. Whole brain radiotherapy with partial hair-sparing technique - a feasibility study. Int J Radiol Radiat Ther. 2020;7(4):104-110
  • 21. Hu, YA, et al. How Well Do We Spare Scalp with Image- Guided Rotational IMRT. International Journal of Radiation Oncology, Biology, Physics, 2011; Volume 81, Issue 2, S840
  • 22.Yetmen Dogan O, Cini N, Nasır Can SS. Dosimetric comparison of volumetric modulated arc therapy (VMAT) and Helical tomotherapy for hippocampal avoidance prophylactic whole-brain radiotherapy (HA-PWBRT) in small cell lung cancer: Treatment plans based study. Med J Bakirkoy 2020;16(3):263-71
  • 23.Rong Y, Evans J, Xu-Welliver M, et al. Dosimetric evaluation of intensity-modulated radiotherapy, volumetric modulated arc therapy, and helical tomotherapy for hippocampal- whole brain Radiotherapy. PLoS One. 015;10(4):e0126222
  • 24.Krayenbuehl J, Di Martino M, Guckenberger M, Andratschke N. Improved plan quality with automated radiotherapy planning for whole brain with hippocampus sparing: a arison to the RTOG 0933 trial. Radiat Oncol. 2017 Oct 2;12(1):161
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Research Article
Yazarlar

Mehmet Demirtaş Bu kişi benim

Yayımlanma Tarihi 25 Haziran 2020
Gönderilme Tarihi 28 Mart 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 7 Sayı: 2

Kaynak Göster

Vancouver Demirtaş M. Dosimetric Comparison of Scalp Protection in Whole Brain Radiotherapy Due to Brain Metastasis. ULUTAS MED J. 2020;7(2):69-76.