Evaluation of a dedicated brain metastases treatment planning optimization for radiosurgery: a new treatment paradigm?

Purpose: To investigate the feasibility of a novel dedicated treatment planning solution, to automatically target multiple brain metastases with a single isocenter and multiple inversely-optimized dynamic conformal arcs (DCA), and to benchmark it against the well-established multiple isocenter DCA (...

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Published in:Radiation Oncology Vol. 11; pp. 1 - 8
Main Authors: Gevaert, Thierry, Steenbeke, Femke, Pellegri, Luca, Engels, Benedikt, Christian, Nicolas, Hoornaert, Marie-Thérèse, Verellen, Dirk, Mitine, Carine, De Ridder, Mark
Format: diagnostic images research tables/charts Journal Article
Published: BioMed Central 2/2/2016
Online Access:View this record in EBSCOhost
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      dt: 2/2/2016
      vid: 11
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      pub: BioMed Central
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        10.1186/s13014-016-0593-y
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        atl: Evaluation of a dedicated brain metastases treatment planning optimization for radiosurgery: a new treatment paradigm?
      aug:
        au:
          Gevaert, Thierry
          Steenbeke, Femke
          Pellegri, Luca
          Engels, Benedikt
          Christian, Nicolas
          Hoornaert, Marie-Thérèse
          Verellen, Dirk
          Mitine, Carine
          De Ridder, Mark
        affil: Department of Radiotherapy, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
      sug:
        subj:
          Radiosurgery Methods
          Radiotherapy, Computer-Assisted Methods
          Brain Neoplasms Radiotherapy
          Radiotherapy, Conformal Methods
          Information Science
          Algorithms
          Radiation Dosage
          Benchmarking
          Random Assignment
          Software
          Brain Neoplasms Pathology
          Human
          Neoplasm Metastasis
          Radiometry Methods
          Automation
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
      ab: Purpose: To investigate the feasibility of a novel dedicated treatment planning solution, to automatically target multiple brain metastases with a single isocenter and multiple inversely-optimized dynamic conformal arcs (DCA), and to benchmark it against the well-established multiple isocenter DCA (MIDCA) and volumetric modulated arc therapy (VMAT) approaches.Material and Methods: Ten previously treated patients were randomly selected, each representing a variable number of lesions ranging between 1 to 8. The original MIDCA treatments were replanned with both VMAT and the novel brain metastases tool. The plans were compared by means of Paddick conformity (CI) and gradient index (GI), and the volumes receiving 10 Gy (V10) and 12 Gy (V12).Results: The brain metastases software tool generated plans with similar CI (0.65 ± 0.08) as both established treatment techniques while improving the gradient (mean GI = 3.9 ± 1.4). The normal tissue exposure in terms of V10 (48.5 ± 35.9 cc) and V12 (36.3 ± 27.1 cc) compared similarly to the MIDCA technique and surpassed VMAT plans.Conclusions: The automated brain metastases planning algorithm software is an optimization of DCA radiosurgery by increasing delivery efficiency to the level of VMAT approaches. Improving dose gradients and normal tissue sparing over VMAT, revives DCA as the paradigm for linac-based stereotactic radiosurgery of multiple brain metastases.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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