PURPOSE: To plan craniospinal irradiation with "field-in-field" (FIF) homogenization in combination with daily, intrafractional modulation of the field junctions, to minimize the possibility of spinal cord overdose. METHODS AND MATERIALS: Lateral cranial fields and posterior spinal fields were planned using a forward-planned, step-and-shoot FIF technique. Field junctions were automatically modulated and custom-weighted for maximal homogeneity within each treatment fraction. Dose-volume histogram analyses and film dosimetry were used to assess results. RESULTS: Plan inhomogeneity improved with FIF. Planning with daily modulated junction shifts provided consistent dose delivery during each fraction of treatment across the junctions. Modulation minimized the impact of a 5-mm setup error at the junction. Film dosimetry confirmed that no point in the junction exceeded the anticipated dose. CONCLUSIONS: Field-in-field planning and modulated junction shifts improve the homogeneity and consistency of daily dose delivery, simplify treatment, and reduce the impact of setup errors.
PURPOSE: To plan craniospinal irradiation with "field-in-field" (FIF) homogenization in combination with daily, intrafractional modulation of the field junctions, to minimize the possibility of spinal cord overdose. METHODS AND MATERIALS: Lateral cranial fields and posterior spinal fields were planned using a forward-planned, step-and-shoot FIF technique. Field junctions were automatically modulated and custom-weighted for maximal homogeneity within each treatment fraction. Dose-volume histogram analyses and film dosimetry were used to assess results. RESULTS: Plan inhomogeneity improved with FIF. Planning with daily modulated junction shifts provided consistent dose delivery during each fraction of treatment across the junctions. Modulation minimized the impact of a 5-mm setup error at the junction. Film dosimetry confirmed that no point in the junction exceeded the anticipated dose. CONCLUSIONS: Field-in-field planning and modulated junction shifts improve the homogeneity and consistency of daily dose delivery, simplify treatment, and reduce the impact of setup errors.
Authors: Aaron P Brown; Christian L Barney; David R Grosshans; Mary Frances McAleer; John F de Groot; Vinay K Puduvalli; Susan L Tucker; Cody N Crawford; Meena Khan; Soumen Khatua; Mark R Gilbert; Paul D Brown; Anita Mahajan Journal: Int J Radiat Oncol Biol Phys Date: 2013-02-20 Impact factor: 7.038
Authors: Marzanna Chojnacka; Anna Skowrońska-Gardas; Marzena Morawska-Kaczyńska; Anna Zygmuntowicz-Piętka; Katarzyna Pędziwiatr; Anna Semaniak Journal: Rep Pract Oncol Radiother Date: 2010-02-18
Authors: Rebecca M Howell; Annelise Giebeler; Wendi Koontz-Raisig; Anita Mahajan; Carol J Etzel; Anthony M D'Amelio; Kenneth L Homann; Wayne D Newhauser Journal: Radiat Oncol Date: 2012-07-24 Impact factor: 3.481
Authors: Annelise Giebeler; Wayne D Newhauser; Richard A Amos; Anita Mahajan; Kenneth Homann; Rebecca M Howell Journal: Radiat Oncol Date: 2013-02-03 Impact factor: 3.481