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VMAT 기법을 활용한 HA-WBRT에서 빔 배열 변화에 따른 선량학적 인자 비교: 팬텀 연구

Comparison of Dosimetric Parameters Based on Beam Arrangement Changes in HA-WBRT by Using VMAT Technique: A Phantom Study

  • 박성국 (부산대학교병원 방사선종양학과) ;
  • 김동현 (부산가톨릭대학교 보건과학대학 방사선학과)
  • Sung-Kuk Park (Department of Radiation Oncology, Pusan National University Hospital) ;
  • Dong-Hyun Kim (Department of Radiological Science, College of Health Sciences, Catholic University of Pusan)
  • 투고 : 2024.06.10
  • 심사 : 2024.07.04
  • 발행 : 2024.08.31

초록

This study aimed to evaluate the impact of changes in beam arrangement and arc counts on dosimetric factors in volumetric modulated arc therapy (VMAT) inverse radiation therapy planning for hippocampal-avoidance whole brain radiation therapy (HA-WBRT) by using the Elekta Monaco radiation therapy planning system (RTPs). For coplanar VMAT, both the arc per beam (APB) method and the beam determined arc(BDA) method, which is determined by the number of beams, were applied. For non-coplanar VMAT, the BDA method was utilized, and a total of 9 treatment plans were established by varying the arc counts. All radiation therapy plans met the radiation oncology group (RTOG) 0933 protocol standards, and 14 dosimetric factors were compared and analyzed. The results showed that the BDA-NC VMAT method demonstrated superior performance in terms of planning target volume (PTV) coverage and protection of normal organs, while APB-VMAT was advantageous in terms of hippocampal protection, monitor unit and delivery time. This study is expected to contribute to the efficient establishment of HA-WBRT plans considering the changes in beam arrangement and rotation arc numbers in Monaco RTPs.

키워드

참고문헌

  1. de Ruiter MB, Groot PFC, Deprez S, Pullens P, Sunaert S, de Ruysscher D, et al. Hippocampal avoidance prophylactic cranial irradiation (HA-PCI) for small cell lung cancer reduces hippocampal atrophy compared to conventional PCI. Neuro-oncology. 2023;25(1):167-76. DOI: 10.1093/neuonc/noac148
  2. Chiang PY, Chang CC, Lee CY, Wang YW, Tsang YW, Hung CH. Hippocampal-sparing whole-brain radiotherapy under coplanar or noncoplanar VMAT. Medical Dosimetry. 2023;48(3):134-9. DOI: 10.1016/j.meddos.2023.02.002
  3. Aijun J, Weipeng S, Fen Z, Zhenxuan W, Dongping S, Qingxi Y, et al. Dosimetric evaluation of four whole brain radiation therapy approaches with hippocampus and inner ear avoidance and simultaneous integrated boost for limited brain metastases. Radiation Oncology. 2019;14(1):1-8. DOI: 10.1186/s13014-019-1255-7
  4. Alejandro P, Ana Isabel M, Eduardo C, Raul D, Alejandro F, Gustavo P, et al. Dosimetric comparison of four volumetric-modulated arc therapy beam arrangements utilized for hippocampal-sparing whole-brain radiation therapy. Journal of Medical Physics. 2019;44(1):1-8. DOI: 10.4103/jmp.JMP_56_18
  5. Trifiletti DM, Brown PD. The role of whole-brain radiation therapy in patients with cerebral metastases. Cancer. 2018;124(10):2072-4. DOI: 10.1002/cncr.31352
  6. Lee YW, Cho HJ, Lee WH, Sonntag WE. Whole brain radiation-induced cognitive impairment: pathophysiological mechanisms and therapeutic targets. Biomolecules & Therapeutics. 2012;20(4):357-70. DOI: 10.4062/biomolther.2012.20.4.357
  7. Kim SH, Kim HT. Functional neuroanatomy of learning and memory. The Korean Journal of Sychopathology. 1999;8(1):22-34. Retrived from https://kiss.kstudy.com/Detail/Ar?key=1809894
  8. Xue J, Jin S, Zhang H, Zou K, Sheng J, Tang J, et al. A simplified non-coplanar volumetric modulated arc therapy for the whole brain radiotherapy with hippocampus avoidance. Frontiers in Oncology. 2023;13:1143564. DOI: 10.3389/fonc.2023.1143564
  9. Yuen AHL, Wu PM, Li AKL, Mak PCY. Volumetric modulated arc therapy (VMAT) for hippocampal-avoidance whole brain radiation therapy: Planning comparison with Dual-arc and Split-arc partial-field techniques. Radiation Oncology. 2020;15(1):1-10. DOI: 10.1186/s13014-020-01488-5
  10. Hogstrom KR, Almond PR. Review of electron beam therapy physics. Physics in Medicine and Biology. 2006;51(13):R455-R89. DOI: 10.1088/0031-9155/51/13/R25
  11. Brown PD, Laack NN, Gondi V, Pugh S, Deshmukh S, Tome WA, et al. Hippocampal avoidance during whole-brain radiotherapy plus memantine for patients with brain metastases: Phase III trial NRG oncology CC001. Journal of Clinical Oncology. 2020;38(10):1019-29. DOI: 10.1200/JCO.19.02767
  12. Gondi V, Rowley H, Pugh SL, Shi W, DeNittis A, Konski AA, et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933): A phase II multi-institutional trial. Journal of Clinical Oncology. 2014;32(34):3810-6. DOI: 10.1200/JCO.2014.57.2909
  13. Kazda T, Jancalek R, Pospisil P, Sevela O, Prochazka T, Vrzal M, et al. Why and how to spare the hippocampus during brain radiotherapy: The developing role of hippocampal avoidance in cranial radiotherapy. Radiation Oncology. 2014;9(1):1-22. DOI: 10.1186/1748-717X-9-139
  14. Grosu AL, Frings L, Bentsalo I, Oehlke O, Brenner F, Bilger A, et al. Whole-brain irradiation with hippocampal sparing and dose escalation on metastases: Neurocognitive testing and biological imaging (HIPPORAD) - A phase II prospective randomized multicenter trial (NOA-14, ARO 2015-3, DKTK-ROG). BMC Cancer. 2020;20(1):1-13. DOI: 10.1186/s12885-020-07011-z
  15. Nevelsky A, Kaidar-Person O, Bar-Deroma R, Nasrallah H, Ben-Yosef R, Kuten A, et al. Hippocampal-sparing whole-brain radiotherapy using the elekta equipment. J Appl Clin Med Phys. 2013;14(3):113-20. DOI: 10.1120/jacmp.v14i3.4205
  16. Yuen AHL, Wu PM, Li AKL, Mak PCY. Hybrid split-arc partial-field volumetric modulated arc therapy: an improved beam arrangement for linear accelerator-based hippocampal-avoidance whole brain radiation therapy. Reports of Practical Oncology and Radiotherapy. 2022;27(2):352-9. DOI: 10.5603/RPOR.a2022.0022
  17. Kalet AM, Richardson HL, Nikolaisen DA, Cao N, Lavilla MA, Dempsey C, et al. Dosimetric comparison of single-beam multi-arc and 2-beam multi-arc VMAT optimization in the Monaco treatment planning system. Preprint. 2017;42(2):122-5. DOI: 10.1016/J.MEDDOS.2017.02.001
  18. Pudsey LM, Cutajar D, Wallace A, Saba A, Schmidt L, Bece A, et al. The use of collimator angle optimization and jaw tracking for VMAT-based single-isocenter multiple-target stereotactic radiosurgery for up to six targets in the Varian Eclipse treatment planning system. J Appl Clin Med Phys. 2021;22(9):171-82. DOI: 10.1002/acm2.13360
  19. Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M. Is a single arc sufficient in volumetric-modulated arc therapy (VMAT) for complex-shaped target volumes? Radiotherapy and Oncology. 2009;93(2):259-65. DOI: 10.1016/j.radonc.2009.08.015
  20. Chang DS, Lasley FD, Das IJ, Mendonca MS, Dynlacht JR, Chang DS, et al. Therapeutic ratio. Basic Radiotherapy Physics and Biology. 2021:307-12. DOI: 10.1007/978-3-030-61899-5_30
  21. Shen J, Bender E, Yaparpalvi R, Kuo HC, Basavatia A, Hong L, et al. An efficient Volumetric Arc Therapy treatment planning approach for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT). Preprint. 2015;40(3):205-9. DOI: 10.1016/J.MEDDOS.2014.11.007