Conventionally-fractionated image-guided intensity modulated radiotherapy (IG-IMRT): a safe and effective treatment for cancer spinal metastasis.

Radiation Oncology
Youling GongFeng Xu

Abstract

Treatments for cancer spinal metastasis were always palliative. This study was conducted to investigate the safety and effectiveness of IG-IMRT for these patients. 10 metastatic lesions were treated with conventionally-fractionated IG-IMRT. Daily kilovoltage cone-beam computed tomography (kV-CBCT) scan was applied to ensure accurate positioning. Plans were evaluated by the dose-volume histogram (DVH) analysis. Before set-up correction, the positioning errors in the left-right (LR), superior-inferior (SI) and anterior-posterior (AP) axes were 0.3 +/- 3.2, 0.4 +/- 4.5 and -0.2 +/- 3.9 mm, respectively. After repositioning, those errors were 0.1 +/- 0.7, 0 +/- 0.8 and 0 +/- 0.7 mm, respectively. The systematic/random uncertainties ranged 1.4-2.3/3.0-4.1 before and 0.1-0.2/0.7-0.8 mm after online set-up correction. In the original IMRT plans, the average dose of the planning target volume (PTV) was 61.9 Gy, with the spinal cord dose less than 49 Gy. Compared to the simulated PTVs based on the pre-correction CBCT, the average volume reduction of PTVs was 42.3% after online correction. Also, organ at risk (OAR) all benefited from CBCT-based set-up correction and had significant dose reduction with IGRT technique. Clinically, most pat...Continue Reading

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Citations

Dec 18, 2008·Radiation Oncology·Anne RichterMichael Flentje
Jan 2, 2010·Radiation Oncology·Pei-Wei ShuengChen-Hsi Hsieh
Jan 8, 2013·Journal of Medical Physics·Tejinder KatariaShyam S Bisht
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Dec 7, 2020·Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists·Hardev S GrewalHosang Jin

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