全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Planning Target Volume Margin in Linac-Based Stereotactic Radiosurgery for Brain Metastases

DOI: 10.4236/jct.2024.157025, PP. 265-272

Keywords: SRS, Brain Metastases, PTV

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: The treatment of brain metastases with radiotherapy has shifted to the use of Stereotactic Radio-surgery (SRS). The technical issue of expanding the treatment volume around the Gross Tumor Volume (GTV) is a current debate. Radiotherapy centers use variable GTV-PTV margins, ranging from one to 2 mm. Material and Methods: We performed a dosimetric comparison in plans of twenty patients using three margins: PTV zero, PTV1, and PTV2. We also developed imaginary Peel volumes. These volumes are described as follows: Peel1 = PTV1 ? GTV, Peel2 = PTV2 ? GTV. Results: Our results showed that the mean PTV volume differed significantly across the different margins (p = 0.000). The V12 of the brain significantly varied as a function of PTV margin (p = 0.000). The target coverage and plan quality indices were not significantly different. The Peel volume dosimetric analysis showed that the mean dose was significantly higher in the nearby normal brain tissue: Peel1 (p = 0.022) and Peel 2 (p = 0.013). Conclusion: According to our dosimetric analysis, expanding the GTV into a PTV by 1 mm margin is more convenient than 2 mm.

References

[1]  Katano, A. and Yamashita, H. (2022) Brain Metastasis: Recent Treatment Modalities and Future-Perspectives. Oncology Letters, 23, Article No. 191.
https://doi.org/10.3892/ol.2022.13311
[2]  Schiff, D., Messersmith, H., Brastianos, P.K., Brown, P.D., Burri, S., Dunn, I.F., Gaspar, L.E., Gondi, V., Jordan, J.T., Maues, J., Mohile, N., Redjal, N., Stevens, G.H.J., Sulman, E.P., van den Bent, M., Wallace, H.J., Zadeh, G. and Vogelbaum, M.A. (2022) Radiation Therapy for Brain Metastases: ASCO Guideline Endorsement of ASTRO Guideline. Journal of Clinical Oncology, 40, 2271-2276.
https://doi.org/10.1200/JCO.22.00333
[3]  Badloe, J., Mast, M., Petoukhova, A., et al. (2021) Impact of PTV Margin Reduction (2 mm to 0 mm) on Pseudoprogression in Stereotactic Radiotherapy of Solitary Brain Metastases. Technical Innovations and Patient Support in Radiation Oncology, 17, 40-47.
https://doi.org/10.1016/j.tipsro.2021.02.008
[4]  Noel, G., Simon, J.M., Valery, C.A., et al. (2003) Radiosurgery for Brain Metastasis: Impact of CTV on Local Control. Radiotherapy Oncology, 68, 15-21.
https://doi.org/10.1016/S0167-8140(03)00207-X
[5]  Diez, P., Hanna, G.G., Aitken, K.L., van As, N., Carver, A., Colaco, R.J., et al. (2022) UK 2022 Consensus on Normal Tissue Dose-Volume Constraints for Oligometastatic, Primary Lung and Hepatocellular Carcinoma Stereotactic Ablative Radiotherapy. Clinical Oncology, 34, 288-300.
https://doi.org/10.1016/j.clon.2022.02.010
[6]  Ma, L., Sahgal, A., Larson, D.A., et al. (2014) Impact of Millimeter-Level Margins on Peripheral Normal Brain Sparing for Gamma Knife Radiosurgery. International Journal of Radiation Oncology, Biology, Physics, 89, 206-213.
https://doi.org/10.1016/j.ijrobp.2014.01.011
[7]  Kirkpatrick, J.P., Wang, Z.H., et al. (2015) Defining the Optimal Planning Target Volume in Image-Guided Stereotactic Radiosurgery of Brain Metastases: Results of a Randomized Trial. International Journal of Radiation Oncology, Biology, Physics, 91, 100-108.
https://doi.org/10.1016/j.ijrobp.2014.09.004
[8]  Shaw, E., Scott, C., Souhami, L., et al. (2000) Single Dose Radiosurgical Treatment of Recurrent Previously Irradiated Primary Brain Tumors and Brain Metastases: Final Report of RTOG Protocol 90-05. International Journal of Radiation Oncology, Biology, Physics, 47, 291-298.
https://doi.org/10.1016/S0360-3016(99)00507-6
[9]  Baumert, B.G., Rutten, I., Dehing-Oberije, C., Twijnstra, A., Dirx, M.J., Debougnoux-Huppertz, R.M., Lambin, P. and Kubat, B. (2006) A Pathology-Based Substrate for Target Definition in Radiosurgery of Brain Metastases. International Journal of Radiation Oncology, Biology, Physics, 66, 187-194.
https://doi.org/10.1016/j.ijrobp.2006.03.050
[10]  Tudor, G.S.J., Bernstein, D., Riley, S., Rimmer, Y., Thomas, S.J., van Herk, M. and Webster, A. (2020) Geometric Uncertainties in Daily Online IGRT: Refining the CTV-PTV Margin for Contemporary Radiotherapy British Institute of Radiology.

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133