PURPOSE: The purpose of this study was to investigate the dosimetric feasibility of liver stereotactic body radiation therapy (SBRT) using a teletherapy system equipped with 3 rotating (60)Co sources (tri-(60)Co system) and a built-in magnetic resonance imager (MRI). We hypothesized tumor size and location would be predictive of favorable dosimetry with tri-(60)Co SBRT. METHODS AND MATERIALS: The primary study population consisted of 11 patients treated with SBRT for malignant hepatic lesions whose linear accelerator (LINAC)-based SBRT plans met all mandatory Radiation Therapy Oncology Group (RTOG) 1112 organ-at-risk (OAR) constraints. The secondary study population included 5 additional patients whose plans did not meet the mandatory constraints. Patients received 36 to 60 Gy in 3 to 5 fractions. Tri-(60)Co system SBRT plans were planned with ViewRay system software. RESULTS: All patients in the primary study population had tri-(60)Co SBRT plans that passed all RTOG constraints, with similar planning target volume coverage and OAR doses to LINAC plans. Mean liver doses and V10Gy to the liver, although easily meeting RTOG 1112 guidelines, were significantly higher with tri-(60)Co plans. When the 5 additional patients were included in a univariate analysis, the tri-(60)Co SBRT plans were still equally able to pass RTOG constraints, although they did have inferior ability to pass more stringent liver and kidney constraints (P < .05). A multivariate analysis found the ability of a tri-(60)Co SBRT plan to meet these constraints depended on lesion location and size. Patients with smaller or more peripheral lesions (as defined by distance from the aorta, chest wall, liver dome, and relative lesion volume) were significantly more likely to have tri-(60)Co plans that spared the liver and kidney as well as LINAC plans did (P < .05). CONCLUSIONS: It is dosimetrically feasible to perform liver SBRT with a tri-(60)Co system with a built-in MRI. Patients with smaller or more peripheral lesions are more likely to have optimal liver and kidney sparing, with the added benefit of MRI guidance, when receiving tri-(60)Co-based SBRT.
PURPOSE: The purpose of this study was to investigate the dosimetric feasibility of liver stereotactic body radiation therapy (SBRT) using a teletherapy system equipped with 3 rotating (60)Co sources (tri-(60)Co system) and a built-in magnetic resonance imager (MRI). We hypothesized tumor size and location would be predictive of favorable dosimetry with tri-(60)Co SBRT. METHODS AND MATERIALS: The primary study population consisted of 11 patients treated with SBRT for malignant hepatic lesions whose linear accelerator (LINAC)-based SBRT plans met all mandatory Radiation Therapy Oncology Group (RTOG) 1112 organ-at-risk (OAR) constraints. The secondary study population included 5 additional patients whose plans did not meet the mandatory constraints. Patients received 36 to 60 Gy in 3 to 5 fractions. Tri-(60)Co system SBRT plans were planned with ViewRay system software. RESULTS: All patients in the primary study population had tri-(60)Co SBRT plans that passed all RTOG constraints, with similar planning target volume coverage and OAR doses to LINAC plans. Mean liver doses and V10Gy to the liver, although easily meeting RTOG 1112 guidelines, were significantly higher with tri-(60)Co plans. When the 5 additional patients were included in a univariate analysis, the tri-(60)Co SBRT plans were still equally able to pass RTOG constraints, although they did have inferior ability to pass more stringent liver and kidney constraints (P < .05). A multivariate analysis found the ability of a tri-(60)Co SBRT plan to meet these constraints depended on lesion location and size. Patients with smaller or more peripheral lesions (as defined by distance from the aorta, chest wall, liver dome, and relative lesion volume) were significantly more likely to have tri-(60)Co plans that spared the liver and kidney as well as LINAC plans did (P < .05). CONCLUSIONS: It is dosimetrically feasible to perform liver SBRT with a tri-(60)Co system with a built-in MRI. Patients with smaller or more peripheral lesions are more likely to have optimal liver and kidney sparing, with the added benefit of MRI guidance, when receiving tri-(60)Co-based SBRT.
Authors: Shankar Siva; Gargi Kothari; Alexander Muacevic; Alexander V Louie; Ben J Slotman; Bin S Teh; Simon S Lo Journal: Nat Rev Urol Date: 2017-06-20 Impact factor: 14.432
Authors: Chang Heon Choi; So-Yeon Park; Jung-In Kim; Jin Ho Kim; Kyubo Kim; Joel Carlson; Jong Min Park Journal: Br J Radiol Date: 2016-12-08 Impact factor: 3.039
Authors: Adrian L Breto; Kyle R Padgett; John C Ford; Deukwoo Kwon; Channing Chang; Martin Fuss; Radka Stoyanova; Eric A Mellon Journal: Cureus Date: 2018-03-28
Authors: Stephen A Rosenberg; Lauren E Henke; Narek Shaverdian; Kathryn Mittauer; Andrzej P Wojcieszynski; Craig R Hullett; Mitchell Kamrava; James Lamb; Minsong Cao; Olga L Green; Rojano Kashani; Bhudatt Paliwal; John Bayouth; Paul M Harari; Jeffrey R Olsen; Percy Lee; Parag J Parikh; Michael Bassetti Journal: Adv Radiat Oncol Date: 2018-08-23
Authors: Luca Boldrini; Elisa Placidi; Nicola Dinapoli; Luigi Azario; Francesco Cellini; Mariangela Massaccesi; Silvia Chiesa; Maria Antonietta Gambacorta; Gian Carlo Mattiucci; Danila Piccari; Stefania Teodoli; Marco De Spirito; Vincenzo Valentini Journal: Tech Innov Patient Support Radiat Oncol Date: 2018-03-31