Clinical implementation of HyperArc
Tóm tắt
The aim of this study was to present our experience on clinical implementation of HyperArc including dosimetric comparison between VMAT and HyperArc plans and dosimetric verification of HyperArc. In this study, eleven previously treated cases of brain metastasis were selected from our brain stereotactic radiotherapy program. The cases were retrospectively planned using HyperArc technique and the plan quality was evaluated. In addition, dosimetric effects of HyperArc plan with different energies and using jaw tracking technique were evaluated. Furthermore, dosimetric verification of HyperArc plans was performed using ion chamber and radiochromic film. Our results of dosimetric comparison shows that HyperArc technique improved both conformity index and gradient index compared to VMAT plans. We also found that using 6MV flattening filter free (6MV-FFF) beam improves gradient index in HyperArc plans compared to using 6MV flattening filter beam. Furthermore, our results show that jaw tracking technique reduces the size of low dose volume while maintaining similar target coverage, conformity index, and gradient index. In our dosimetric verification study, results of ion chamber and film measurement indicate no significant difference between VMAT and HyperArc plans. In conclusion, HyperArc simplifies planning of stereotactic treatment for brain and improves the dosimetry in treatment plans. Additionally, HyperArc provides for a safe and efficient treatment delivery system for stereotactic treatments to brain.
Tài liệu tham khảo
Gu L et al (2019) Stereotactic radiation therapy (SRT) for brain metastases of multiple primary tumors: a single institution retrospective analysis. Front Oncol 9:1352. https://doi.org/10.3389/fonc.2019.01352
Tsao MN et al (2012) Radiotherapeutic and surgical management for newly diagnosed brain metastasis(es): an american society for radiation oncology evidence-based guideline. Pract Radiat Oncol 2(3):210–225. https://doi.org/10.1016/j.prro.2011.12.004
Eichler AF, Loeffler JS (2007) Multidisciplinary management of brain metastases. Oncologist 12(7):884–898. https://doi.org/10.1634/theoncologist.12-7-884
Siddiqui ZA et al (2020) Predictors of radiation necrosis in long-term survivors after Gamma Knife stereotactic radiosurgery for brain metastases. Neurooncol Pract 7(4):400–408. https://doi.org/10.1093/nop/npz067
Manning MA et al (2000) Hypofractionated stereotactic radiotherapy as an alternative to radiosurgery for the treatment of patients with brain metastases. Int J Radiat Oncol Biol Phys 47(3):603–608. https://doi.org/10.1016/s0360-3016(00)00475-2
Fokas E et al (2012) Stereotactic radiosurgery and fractionated stereotactic radiotherapy: comparison of efficacy and toxicity in 260 patients with brain metastases. J Neurooncol 109(1):91–98. https://doi.org/10.1007/s11060-012-0868-6
Jhaveri J et al (2018) Does size matter? Investigating the optimal planning target volume margin for postoperative stereotactic radiosurgery to resected brain metastases. J Neurosurg 130(3):797–803. https://doi.org/10.3171/2017.9.JNS171735
Aoyama H et al (2003) Hypofractionated stereotactic radiotherapy alone without whole-brain irradiation for patients with solitary and oligo brain metastasis using noninvasive fixation of the skull. Int J Radiat Oncol Biol Phys 56(3):793–800. https://doi.org/10.1016/s0360-3016(03)00014-2
Minniti G et al (2016) Single-fraction versus multifraction (3 x 9 Gy) stereotactic radiosurgery for large (>2 cm) brain metastases: a comparative analysis of local control and risk of radiation-induced brain necrosis. Int J Radiat Oncol Biol Phys 95(4):1142–1148. https://doi.org/10.1016/j.ijrobp.2016.03.013
Ohira S et al (2018) HyperArc VMAT planning for single and multiple brain metastases stereotactic radiosurgery: a new treatment planning approach. Radiat Oncol 13(1):13. https://doi.org/10.1186/s13014-017-0948-z
Ruggieri R et al (2018) Linac-based VMAT radiosurgery for multiple brain lesions: comparison between a conventional multi-isocenter approach and a new dedicated mono-isocenter technique. Radiat Oncol 13(1):38. https://doi.org/10.1186/s13014-018-0985-2
Ruggieri R et al (2019) Linac-based radiosurgery for multiple brain metastases: comparison between two mono-isocenter techniques with multiple non-coplanar arcs. Radiother Oncol 132:70–78. https://doi.org/10.1016/j.radonc.2018.11.014
Slosarek K et al (2018) In silico assessment of the dosimetric quality of a novel, automated radiation treatment planning strategy for linac-based radiosurgery of multiple brain metastases and a comparison with robotic methods. Radiat Oncol 13(1):41. https://doi.org/10.1186/s13014-018-0997-y
Kadoya N et al (2019) Automated noncoplanar treatment planning strategy in stereotactic radiosurgery of multiple cranial metastases: HyperArc and CyberKnife dose distributions. Med Dosim 44(4):394–400. https://doi.org/10.1016/j.meddos.2019.02.004
Ueda Y et al (2019) Dosimetric performance of two linear accelerator-based radiosurgery systems to treat single and multiplebrain metastases. Br J Radiol 92(1100):20190004. https://doi.org/10.1259/bjr.20190004
Vergalasova I et al (2019) Multi-institutional dosimetric evaluation of modern day stereotactic radiosurgery (SRS) treatment options for multiple brain metastases. Front Oncol 9:483. https://doi.org/10.3389/fonc.2019.00483
Ho HW et al (2020) Dosimetric comparison between RapidArc and HyperArc techniques in salvage stereotactic body radiation therapy for recurrent nasopharyngeal carcinoma. Radiat Oncol 15(1):164. https://doi.org/10.1186/s13014-020-01602-7
Inui S et al (2020) Novel strategy with the automatic non-coplanar volumetric-modulated arc therapy for angiosarcoma of the scalp. Radiat Oncol 15(1):175. https://doi.org/10.1186/s13014-020-01614-3
Popple R, Snyder J (2018) Considerations in designing a commissioning and QA protocol for HyperArc. Varian Medical Systems. http://medicalaffairs.varian.com/index.php?s=20296&cat=3263. Accessed 27 Mar 2019
Wang A et al (2018) Acuros CTS: A fast, linear Boltzmann transport equation solver for computed tomography scatter - Part II: System modeling, scatter correction, and optimization. Med Phys 45(5):1914–1925. https://doi.org/10.1002/mp.12849
Gardner SJ et al (2019) Improvements in CBCT image quality using a novel iterative reconstruction algorithm: a clinical evaluation. Adv Radiat Oncol 4(2):390–400. https://doi.org/10.1016/j.adro.2018.12.003
Snyder KC et al (2018) Evaluation and verification of the QFix Encompass(TM) couch insert for intracranial stereotactic radiosurgery. J Appl Clin Med Phys 19(4):222–229. https://doi.org/10.1002/acm2.12387
Shaw E et al (1993) Radiation therapy oncology group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys 27(5):1231–1239. https://doi.org/10.1016/0360-3016(93)90548-a
Paddick I (2000) A simple scoring ratio to index the conformity of radiosurgical treatment plans Technical note. J Neurosurg 93(Suppl 3):219–222. https://doi.org/10.3171/jns.2000.93.supplement
Paddick I, Lippitz B (2006) A simple dose gradient measurement tool to complement the conformity index. J Neurosurg 105(Suppl):194–201. https://doi.org/10.3171/sup.2006.105.7.194
ICRU (2010) Report 83: prescribing, recording, and reporting photon-beam intensity-modulated radiation therapy (IMRT). J ICRU 10(1):1–106
Lewis D et al (2012) An efficient protocol for radiochromic film dosimetry combining calibration and measurement in a single scan. Med Phys 39(10):6339–6350. https://doi.org/10.1118/1.4754797
Gao J, Liu X (2016) Off-Isocenter Winston-Lutz test for stereotactic radiosurgery/stereotactic body radiotherapy. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 05(02):154–161. https://doi.org/10.4236/ijmpcero.2016.52017
Eclipse Photon and Electron Algorithms Reference Guide 15.5 (2017) Varian Medical Systems. pp 198–200
Kang J et al (2010) A method for optimizing LINAC treatment geometry for volumetric modulated arc therapy of multiple brain metastases. Med Phys 37(8):4146–4154. https://doi.org/10.1118/1.3455286