Initial experience with volumetric IMRT (RapidArc) for intracranial stereotactic radiosurgery

Int J Radiat Oncol Biol Phys. 2010 Dec 1;78(5):1457-66. doi: 10.1016/j.ijrobp.2009.10.005. Epub 2010 Mar 6.

Abstract

Purpose: Initial experience with delivering frameless stereotactic radiotherapy (SRT) using volumetric intensity-modulated radiation therapy (IMRT) delivered with RapidArc is presented.

Methods and materials: Treatment details for 12 patients (14 targets) with a mean clinical target volume (CTV) of 12.8 ± 4.0 cm(3) were examined. Dosimetric indices for conformality, homogeneity, and dose gradient were calculated and compared with published results for other frameless, intracranial SRT techniques, including CyberKnife, TomoTherapy, and static-beam IMRT. Statistics on setup and treatment times and per patient dose validations were examined.

Results: Dose indices compared favorably with other techniques. Mean conformality, gradient, and homogeneity index values were 1.10 ± 0.11, 64.9 ± 14.1, 1.083 ± 0.026, respectively. Median treatment times were 4.8 ± 1.7 min.

Conclusion: SRT using volumetric IMRT is a viable alternative to other techniques and enables short treatment times. This is anticipated to have a positive impact on radiobiological effect and for facilitating wider use of SRT.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Brain Neoplasms* / diagnostic imaging
  • Brain Neoplasms* / pathology
  • Brain Neoplasms* / radiotherapy
  • Brain Neoplasms* / secondary
  • Brain Neoplasms* / surgery
  • Female
  • Humans
  • Immobilization / methods
  • Male
  • Middle Aged
  • Patient Positioning
  • Radiography
  • Radiosurgery / methods*
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Intensity-Modulated / methods*
  • Time Factors
  • Tumor Burden