Abstract：Objective To explore the feasibility and safety of integrated intensity-modulated radiation therapy (IMRT) technology applied in craniospinal irradiation in a supine position. Methods The patients were fixed in a supine position using thermoplastic mask and vacuum mat. Three isocenters with a fixed interval of 20-25 cm were adopted according to the height of patients. A total of 13 beams with a length of 2-3 cm in the overlapping region were included in the treatment plan. Fixed jaw technique was employed and overall calculation was performed by the inverse optimization method. The γ-passing rate and absolute point dose verification were performed for three isocenters and two overlapping regions. Cone-beam CT (CBCT) images were scanned for three isocenters before treatment. The setup error of each isocenter in the x,y and z directions of the same coordinate system was recorded and overall analysis was conducted. Results Among 28 patients,the γ-passing rate (%) of three isocenters and two overlapping regions was 99.36%,99.60%,99.75%,94.77% and 95.09%,whereas the absolute point dose verification error was 1.56%,-1.56%,0.52%,-0.76% and -1.68%,respectively. Twenty-eight patients received 162 groups of IGRT with 486 setup errors from the CBCT images. The average deviation in the x,y and z direction for three isocenters (neck,chest and abdomen) was 0.17 mm,0.10 mm,0.02 mm,0.06 mm,0.04 mm,0.46 mm,0.19 mm,0.26 mm and 0.41 mm,respectively. Conclusions The integrated IMRT techniques for craniospinal irradiation in a supine position is feasible and safe,which is worthy of clinical application.
Cai Xiaojun,Guo Jian,Zhou Juying et al. Feasibility of integrated IMRT technique for craniospinal irradiation in a supine position[J]. Chinese Journal of Radiation Oncology, 2018, 27(12): 1078-1082.
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2018, Vol. 27 
