Evaluation of localization errors for craniospinal axis irradiation delivery using volume modulated arc therapy and proposal of a technique to minimize such errors

Dosimetric comparison of five different techniques for craniospinal irradiation across 15 European centers: analysis on behalf of the SIOP-E-BTG (radiotherapy working group)

“…Furthermore, the effect of patient (re)positioning uncertainties on the dose distribution has not been taken into account in this analysis. In fact, one technique might be more robust than another resulting in smaller detrimental effects on the ideal static dose distribution calculated by the treatment planning system [49][50][51]. Comparing the robustness of the different techniques is part of a future work.…”

Plan robustness in field junction region from arcs with different patient orientation in total marrow irradiation with VMAT

“…Therefore overlap regions are necessary in order to avoid hot or cold doses around the field junctions as demonstrated for cranial spinal irradiation [14,16] and by Surucu et al for TMI [11]. In a recent paper we investigated the dosimetric consequences of inaccurate isocenter positioning during the TMI and TMLI treatments using VMAT technique with particular attention to the overlapping regions between successive isocenters [12].…”

Reducing the dosimetric impact of positional errors in field junctions for craniospinal irradiation using VMAT

“…However, a recent study [26] dealing with the robustness of treatment plans with respect to positional shifts of the patient claims that the authors specifically aimed for a sigmoidal dose profile in the field overlap region. In another study on localization errors [11] the authors propose a staircase dose profile in order to minimize such errors. An interesting feature of this study is that the authors actually arrived at a linear ramp profile when the junction region was too narrow to support staircase dose profile ( [11], Fig.…”