Variable dose interplay effects across radiosurgical apparatus in?treating multiple brain metastases

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• 作者：Lijun Ma (1)
  Alan Nichol (2)
  Sabbir Hossain (3)
  Brian Wang (4)
  Paula Petti (5)
  Rosemin Vellani (2)
  Chris Higby (3)
  Salahuddin Ahmad (3)
  Igor Barani (1)
  Dennis C. Shrieve (6)
  David A. Larson (1) (5)
  Arjun Sahgal (7)
  
• 关键词：Stereotactic radiosurgery ; Gamma Knife ; Intensity modulation ; Brain metastases
• 刊名：International Journal of Computer Assisted Radiology and Surgery
• 出版年：2014
• 出版时间：November 2014
• 年：2014
• 卷：9
• 期：6
• 页码：1079-1086
• 全文大小：1,108 KB
• 参考文献：1. Tsao MN, Lloyd N, Wong RK, Chow E, Rakovitch E, Laperriere N, Xu W, Sahgal A (2012) Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev 4:CD003869. doi:10.1002/14651858.CD003869.pub3
  2. Tsao M, Xu W, Sahgal A (2012) A meta-analysis evaluating stereotactic radiosurgery, whole-brain radiotherapy, or both for patients presenting with a limited number of brain metastases. Cancer 118(9):2486-493. doi:10.1002/cncr.26515 CrossRef
  3. Yamamoto M, Kawabe T, Sato Y, Higuchi Y, Nariai T, Barfod BE, Kasuya H, Urakawa Y (2013) A case-matched study of stereotactic radiosurgery for patients with multiple brain metastases: comparing treatment results for 1- \(\text{ vs } \ge 5\) tumors: clinical article. J Neurosurg 118(6):1258-268. doi: 10.3171/2013.3.JNS121900 CrossRef
  4. Grandhi R, Kondziolka D, Panczykowski D, Monaco EA 3rd, Kano H, Niranjan A, Flickinger JC, Lunsford LD (2012) Stereotactic radiosurgery using the Leksell Gamma Knife Perfexion unit in the management of patients with 10 or more brain metastases. J Neurosurg 117(2):237-45. doi:10.3171/2012.4.JNS11870
  5. Ma L, Petti P, Wang B, Descovich M, Chuang C, Barani IJ, Kunwar S, Shrieve DC, Sahgal A, Larson DA (2011) Apparatus dependence of normal brain tissue dose in stereotactic radiosurgery for multiple brain metastases. J Neurosurg 114(6):1580-584. doi:10.3171/2011.1.JNS101056
  6. Ling CC, Zhang P, Archambault Y, Bocanek J, Tang G, Losasso T (2008) Commissioning and quality assurance of RapidArc radiotherapy delivery system. Int J Radiat Oncol Biol Phys 72(2):575-81. doi:10.1016/j.ijrobp.2008.05.060
  7. Clark GM, Popple RA, Young PE, Fiveash JB (2010) Feasibility of single-isocenter volumetric modulated arc radiosurgery for treatment of multiple brain metastases. Int J Radiat Oncol Biol Phys 76(1):296-02. doi:10.1016/j.ijrobp.2009.05.029 CrossRef
  8. Ma L, Sahgal A, Hwang A, Hu W, Descovich M, Chuang C, Barani I, Sneed PK, McDermott M, Larson DA (2011) A two-step optimization method for improving multiple brain lesion treatments with robotic radiosurgery. Technol Cancer Res Treat 10(4):331-38
  9. Paddick I, Lippitz B (2006) A simple dose gradient measurement tool to complement the conformity index. J Neurosurg 105(Suppl):194-01. doi:10.3171/sup.2006.105.7.194
  10. Ma L, Sahgal A, Descovich M, Chuang C, Huang K, Shrieve DC, Larson D (2010) Equivalence in dose fall-off for isocentric and non-isocentric intracranial treatment modalities and its impact on dose fractionation schemes. Int J Radiat Oncol Biol Phys 76(3):943-48. doi:10.1016/j.ijrobp.2009.07.1721 CrossRef
  11. Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG, Arbuckle RB, Swint JM, Shiu AS, Maor MH, Meyers CA (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial. Lancet Oncol 10(11):1037-044 CrossRef
  12. Sun A, Bae K, Gore EM, Movsas B, Wong SJ, Meyers CA, Bonner JA, Schild SE, Gaspar LE, Bogart JA, Werner-Wasik M, Choy H (2011) Phase III trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non-small-cell lung cancer: neurocognitive and quality-of-life analysis. J Clin Oncol 29(3):279-86 CrossRef
  13. Sperduto PW, Wang M, Robins HI, Schell MC, Werner-Wasik M, Komaki R, Souhami L, Buyyounouski MK, Khuntia D, Demas W, Shah SA, Nedzi LA, Perry G, Suh JH, Mehta MP (2013) A phase 3 trial of whole brain radiation therapy and stereotactic radiosurgery alone versus WBRT and SRS with temozolomide or erlotinib for non-small cell lung cancer and 1 to 3 brain metastases: Radiation Therapy Oncology Group 0320. Int J Radiat Oncol Biol Phys 85(5):1312-318. doi:
• 作者单位：Lijun Ma (1)
  Alan Nichol (2)
  Sabbir Hossain (3)
  Brian Wang (4)
  Paula Petti (5)
  Rosemin Vellani (2)
  Chris Higby (3)
  Salahuddin Ahmad (3)
  Igor Barani (1)
  Dennis C. Shrieve (6)
  David A. Larson (1) (5)
  Arjun Sahgal (7)
  
  1. Department of Radiation Oncology, University of California, San Francisco, 505 Parnassus Avenue, Room L-08, San Francisco, CA?, 94143, USA
  2. Department of Radiation Oncology, BC Cancer Agency, University of British Columbia, Vancouver, Canada
  3. Department of Radiation Oncology, University of Oklahoma, Oklahoma City, OK, USA
  4. Department of Radiation Oncology, University of Louisville, Louisville, KY, USA
  5. Washington Fremont Hospital Gamma Knife Center, Fremont, CA, USA
  6. Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
  7. Department of Radiation Oncology, Sunnybrook Odette Cancer Center, University of Toronto, Toronto, Canada
  
• ISSN：1861-6429

文摘

Purpose Normal brain tissue doses have been shown to be strongly apparatus dependent for multi-target stereotactic radiosurgery. In this study, we investigated whether inter-target dose interplay effects across contemporary radiosurgical treatment platforms are responsible for such an observation. Methods For the study, subsets ( \(n = 3, 6, 9,\) and 12) of a total of 12 targets were planned at six institutions. Treatment platforms included the (1) Gamma Knife Perfexion (PFX), (2) CyberKnife, (3) Novalis linear accelerator equipped with a 3.0-mm multi-leaf collimator (MLC), and the (4) Varian Truebeam flattening-filter-free (FFF) linear accelerator also equipped with a 2.5?mm MLC. Identical dose–volume constraints for the targets and critical structures were applied for each apparatus. All treatment plans were developed at individual centers, and the results were centrally analyzed. Results We found that dose–volume constraints were satisfied by each apparatus with some differences noted in certain structures such as the lens. The peripheral normal brain tissue doses were lowest for the PFX and highest for TrueBeam FFF and CyberKnife treatment plans. Comparing the volumes of normal brain receiving 12 Gy, TrueBeam FFF, Novalis, and CyberKnife were 180-90?% higher than PFX. The mean volume of normal brain-per target receiving 4-Gy increased by approximately 3.0 cc per target for TrueBeam, 2.7 cc per target for CyberKnife, 2.0 cc per target for Novalis, and 0.82 cc per target for PFX. The beam-on time was shortest with the TrueBeam FFF (e.g., 6-?min at a machine output rate of 1,200 MU/min) and longest for the PFX (e.g., 50-50 mins at a machine output rate of 350?cGy/min). Conclusion The volumes of normal brain receiving 4 and 12 Gy were higher, and increased more swiftly per target, for Linac-based SRS platforms than for PFX. Treatment times were shortest with TrueBeam FFF.