CyberKnife固定与可变准直器颅内SRT计划质量及执行效率应用评价

doi:10.3760/cma.j.issn.1004-4221.2017.11.011

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (3041 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract

Objective To discuss and evaluate the dosimetric characteristics of different plans implementing stereotactic radiotherapy (SRT) for intracranial tumors using Fixed and Iris collimators of CyberKnife VSI. Methods Twenty patients with intracranial tumors were selected and divided into group A with a small target volume (≤30 cm³) and group B with a large target volume (≥30 cm³). There were 10 patients in each group, and the prescribed dose to the target was 21 Gy in 3 fractions. For each patient, two treatment plans were designed using Fixed and Iris collimators. By analyzing the dosimetric parameters such as conformity index (CI), homogeneity index (HI), gradient index (GI), gradient score index (GSI), and organs at risk (OAR), the quality and efficiency of the plans were evaluated in order to discuss the beam characteristics for two sets of collimators. The difference was analyzed with the paired t-test. Resutls The mean time of Iris plan for delivering was significantly less than that of Fixed plan (group A:P=0.001;group B:P=0.000). In group B, the peripheral dose (20% and 10% of the prescribed dose) volumes of Fixed plan were significantly less than those of Iris plan (P=0.001 and 0.009). For OAR, Dmin of the visual pathway and Dmean or Dmin of the eyeball in group B were significantly different between Fixed and Iris plans (all P<0.05), while in group A, only Dmin of the optic chiasm was significantly different between the two plans (P=0.043). For the other parameters of targets, there were no significant differences between Fixed and Iris plans in both groups (all P>0.05). Conclutions Apart from less treatment time in the Iris plan, there are no significant dosimetric differences between the two collimator plans of CyberKnife VSI in treating small intracranial tumor. For the large and complex tumor, although Iris plan meets the requirement for OAR dose constraints, its low-dose volumes are larger than those of Fixed plan. Further studies of the dosimetric characteristics in CyberKnife should be done.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Wang Jinyuan
	Qu Baolin
	Xu Shouping
	Pan Longsheng
	Ju Zhongjian
	Yang Tao
	Xu Wei

Key words： CyberKnife Collimator Plan quality Dosimetric characteristics

Received: 10 October 2016

Corresponding Authors: Xu Shouping,Email;shouping_xu@yahoo.com

Cite this article:

Wang Jinyuan,Qu Baolin,Xu Shouping et al. Evaluation of the quality and efficiency of SRT plans for intracranial tumors using Fixed and Iris collimators of CyberKnife[J]. Chinese Journal of Radiation Oncology, 2017, 26(11): 1292-1297.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.11.011 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I11/1292

[1] Blamek S,Grzadziel A,Miszczyk L.Robotic radiosurgery versus micro-multileaf collimator:a dosimetric comparison for large or critically located arteriovenous malformations[J].Radiat Oncol,2013,8:205.DOI:10.1186/1748-717X-8-205.
[2] Fogh S,Ma L,Gupta N,et al. High-precision volume-staged Gamma Knife surgery and equivalent hypofractionation dose schedules for treating large arteriovenous malformations[J].J Neurosurg,2012,117Suppl.:115-119.DOI:10.3171/2012.7.GKS121023.
[3] Blamek S, Larysz D, Miszczyk L, et al. Hypofractionated stereotactic radiotherapy for large or involving critical organs cerebral arteriovenous malformations. Radiol Oncol 2013,47:50–56.
[4] Gevaert T,Levivier M,Lacornerie T,et al. Dosimetric comparison of different treatment modalities for stereotactic radiosurgery of arteriovenous malformations and acoustic neuromas[J].Radiother Oncol,2013,106(2):192-197.DOI:10.1016/j.radonc.2012.07.002.
[5] Mindermann T.Gamma Knife,CyberKnife or micro-multileaf collimator LINAC for intracranial radiosurgery?[J].Acta Neurochir,2015,157(4):557-558.DOI:10.1007/s00701-015-2351-6.
[6] Dutta D,Subramanian SB,Muli V,et al. Dosimetric comparison of Linac-based (BrainLAB) and robotic radiosurgery (CyberKnife ) stereotactic system plans for acoustic schwannoma[J].J Neurooncol,2012,106(3):637-642.DOI:10.1007/s11060-011-0703-5.
[7] Wowra B,Muacevic A,Tonn JC.Quality of radiosurgery for single brain metastases with respect to treatment technology:a matched-pair analysis[J].J Neurooncol,2009,94:69.DOI:10.1007/s11060-009-9802-y.
[8] Descovich M,Sneed PK,Barbaro NM,et al. A dosimetric comparison between Gamma Knife and CyberKnife treatment plans for trigeminal neuralgia[J].J Neurosurg,2010,113 Suppl.:199-206.
[9] Echner GG,Kilby W,Lee M,et al. The design,physical properties and clinical utility of an iris collimator for robotic radiosurgery[J].Phys Med Biol,2009,54(18):5359-5380.DOI:10.1088/0031-9155/54/18/001.
[10] Timmerman RD.An overview of hypofractionation and introduction to this issue of Seminars in Radiation oncology[J].Semin Radiat Oncol,2008,18(4):215-222.DOI:10.1016/j.semradonc.2008.04.001.
[11] Feuvret L,No ёl G,Mazeron JJ,et al. Conformity index:a review[J].Int J Radiat Oncol Biol Phys,2006,64(2):333-342.DOI:10.1016/j.ijrobp.2005.09.028.
[12] Kataria T,Sharma K,Subramani V,et al. Homogeneity Index:an objective tool for assessment of conformal radiation treatments[J].J Med Phys,2012,37(4):207-213.DOI:10.4103/0971-6203.103606.
[13] Paddick I,Lippitz B.A simple dose gradient measurement tool to complement the conformity index[J].J Neurosurg,2006,105 Suppl.:194-201.DOI:10.3171/sup.2006.105.7.194.
[14] Wagner TH,Bova FJ,Friedman WA,et al. A simple and reliable index for scoring rival stereotactic radiosurgery plans[J].Int J Radiat Oncol Biol Phys,2003,57(4):1141-1149.DOI:10.1016/S0360-3016(03)01563-3.
[15] Di Betta E,Fariselli L,Bergantin A,et al. Evaluation of the peripheral dose in stereotactic radiotherapy and radiosurgery treatments[J].Med Phys,2010,37(7):3587-3594.DOI:10.1118/1.3447724.
[16] Vlachopoulou V,Antypas C,Delis H,et al. Peripheral doses in patients undergoing Cyberknife treatment for intracranial lesions. A single centre experience[J].Radiat Oncol,2011,6:157.DOI:10.1186/1748-717X-6-157.
[17] Ma LJ,Nichol A,Hossain S,et al. Variable dose interplay effects across radiosurgical apparatus in treating MU ltiple brain metastases[J].Int J Comput Assist Radiol Surg,2014,9(6):1079-1086.DOI:10.1007/s11548-014-1001-4.
[18] 朴俊杰,徐寿平,巩汉顺,等.CyberKnife系统技术评估和临床应用评价[J].医疗卫生装备,2016,37(3):114-117.DOI:10.7687/J.ISSN1003-8868.2016.03.114.
Piao JJ,Xu SP,Gong HS,et al. Assessment of technology and clinical application of CyberKnife system[J].Chin Med Equip J,2016,37(3):114-117.DOI:10.7687/J.ISSN1003-8868.2016.03.114.
[19] P ll JJ,Hoogeman MS,Prévost JB,et al. Reducing monitor units for robotic radiosurgery by optimized use of MUltiple collimators[J].Med Phys,2008,35(6):2294-2299.DOI:10.1118/1.2919090.