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Volumetric Modulated Arc Therapy (VMAT) Craniospinal Irradiation (CSI) for Children and Adults: A Practical Guide for Implementation
- Source :
- Practical Radiation Oncology. 12:e101-e109
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Purpose Volumetric modulated arc therapy (VMAT) craniospinal irradiation (CSI) has been shown to have significant dosimetric advantages compared to 3D-conformal therapy, but is a technically complex process. We sought to develop a guide for all aspects of the VMAT CSI process and report patient dosimetry results. Methods and materials We initiated VMAT CSI in 2017 and have regularly revised our standard operating procedure (SOP) for this process since then. Herein, we report a detailed template for the entire VMAT CSI process from initial patient setup and immobilization at time of CT simulation to contouring and treatment planning, quality assurance, and therapy delivery. The records of 12 patients who were treated with VMAT CSI were also retrospectively reviewed. Results Patient age ranged from 2 to 59 years with 5 pediatric patients (age 35 years). The majority of patients (67%) had medulloblastoma. CSI dose ranged from 21.6 Gy to 36 Gy, with a median of 36 Gy. The median CSI planning target volume (PTV) was 2383cc with a median V95% of 99.8% and median 0.03 cc hotspot of 112.5%. The average V107% was 7.4% and the average conformality index was 1.01. Conclusions VMAT CSI has potentially significant dosimetric and acute toxicity advantages compared to 3D-conformal. However, proper procedures need to be in place throughout the process in order to be able to realize these potential advantages. We herein describe our detailed SOP for VMAT CSI. Recognizing the scarcity of proton beam centers in many areas, VMAT CSI represents a feasible treatment with more widespread availability.
- Subjects :
- Adult
Organs at Risk
Adolescent
Planning target volume
Craniospinal Irradiation
Young Adult
Patient age
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Cerebellar Neoplasms
Child
Radiation treatment planning
Aged
Retrospective Studies
Contouring
business.industry
Radiotherapy Planning, Computer-Assisted
Radiotherapy Dosage
Middle Aged
Volumetric modulated arc therapy
Oncology
Child, Preschool
Patient dosimetry
Radiotherapy, Intensity-Modulated
business
Nuclear medicine
Quality assurance
Subjects
Details
- ISSN :
- 18798500
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Practical Radiation Oncology
- Accession number :
- edsair.doi.dedup.....53c54bf7a5ee54cfcea2e7cb7b10c52c