PURPOSE: This study evaluates a possible advantage of intensity-modulated stereotactic radiotherapy (IMSRT) over stereotactic conformal radiotherapy (SCRT) in the treatment of lesions in the base of the skull. METHODS AND MATERIALS: Ten patients (7 with a skull base meningioma) planned for routine SCRT were replanned for IMSRT. The criteria for comparison were the same for both methods: optimal dose to the planning target volume (PTV) and optimal sparing of the organs at risk (OAR). For SCRT, sparing of OAR was achieved by conformal avoidance using 5-6 fields. The IMSRT inverse planning process used optimized OAR sparing through user-defined dose constraints. Dose to the PTV and OAR were assessed by dose-volume histograms, maximum dose, 2 conformity indices, and volumes of relevant isodoses. RESULTS: The conformity index is consistently higher for IMSRT, the largest improvement being for the multifocal and irregular cases. Volumes of the 90% and 80% isodoses were smaller for IMSRT, whereas the volume of the 30% isodose was larger for IMSRT in 6 cases. The maximum dose was consistently higher for IMSRT (mean values 102% and 108% for SCRT and IMSRT, respectively). Sparing of OAR was better with IMSRT, especially for those OARs situated in or near a concave PTV. CONCLUSIONS: In terms of PTV coverage, there is an advantage in using IMSRT for all target shapes, but especially for irregular and concave targets. The dose to OAR is lower with IMSRT, although the volume of normal tissue receiving a low dose can be larger than for SCRT.
PURPOSE: This study evaluates a possible advantage of intensity-modulated stereotactic radiotherapy (IMSRT) over stereotactic conformal radiotherapy (SCRT) in the treatment of lesions in the base of the skull. METHODS AND MATERIALS: Ten patients (7 with a skull base meningioma) planned for routine SCRT were replanned for IMSRT. The criteria for comparison were the same for both methods: optimal dose to the planning target volume (PTV) and optimal sparing of the organs at risk (OAR). For SCRT, sparing of OAR was achieved by conformal avoidance using 5-6 fields. The IMSRT inverse planning process used optimized OAR sparing through user-defined dose constraints. Dose to the PTV and OAR were assessed by dose-volume histograms, maximum dose, 2 conformity indices, and volumes of relevant isodoses. RESULTS: The conformity index is consistently higher for IMSRT, the largest improvement being for the multifocal and irregular cases. Volumes of the 90% and 80% isodoses were smaller for IMSRT, whereas the volume of the 30% isodose was larger for IMSRT in 6 cases. The maximum dose was consistently higher for IMSRT (mean values 102% and 108% for SCRT and IMSRT, respectively). Sparing of OAR was better with IMSRT, especially for those OARs situated in or near a concave PTV. CONCLUSIONS: In terms of PTV coverage, there is an advantage in using IMSRT for all target shapes, but especially for irregular and concave targets. The dose to OAR is lower with IMSRT, although the volume of normal tissue receiving a low dose can be larger than for SCRT.
Authors: Randy L Jensen; Peter R Jensen; Annabelle F Shrieve; Lisa Hazard; Dennis C Shrieve Journal: J Neurooncol Date: 2010-05-12 Impact factor: 4.130
Authors: Hendrik A Wolff; Daniela M Wagner; Hans Christiansen; Clemens F Hess; Hilke Vorwerk Journal: Radiat Oncol Date: 2010-09-13 Impact factor: 3.481
Authors: Barbara Gehler; Frank Paulsen; Mehmet O Oksüz; Till-Karsten Hauser; Susanne M Eschmann; Roland Bares; Christina Pfannenberg; Michael Bamberg; Peter Bartenstein; Claus Belka; Ute Ganswindt Journal: Radiat Oncol Date: 2009-11-18 Impact factor: 3.481