Total scalp radiation using image-guided IMRT for progressive cutaneous T cell lymphoma

Samant, Rajiv; Fox, Greg; Gerig, L; Montgomery, Lynn; Allan, David S.

doi:10.1259/bjr/61338036

Cited by 19 publications

(19 citation statements)

References 12 publications

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“…[41] In the 2000s, these obstacles were partially solved with advanced technology modern RT techniques in combination with IMRT or photon-electron combination therapy techniques; problems in field composition were minimized while the target dose wrapping and dose homogeneity were improved. [41][42][43][44] As of 2009, it was observed that the TSI approach range extends from photon-electron based combined techniques to include IMRT, VMAT, tomotherapy, and high-dose rate brachytherapy. [45][46][47] When VMAT plans with the RapidArc software were implemented in 2017, it was considered as a new choice for TSI.…”

Section: Discussionmentioning

confidence: 99%

Total Scalp Irradiation: The Comparison of Five Different Plans Using Volumetric Modulated Arc Therapy- Simultaneous Integrated Boost (VMAT-SIB) Technique

Rakıcı¹

2017

TJ Oncol

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OBJECTIVEThe aim of this study was to show that the optimum dosage can be delivered to the target organs at risk (OAR) by radiotherapy, which becomes more complicated because of technical difficulties arising from irregular, convex, and complex geometrical structure of the target, such as scalp irradiation, and because of situations resulting from the necessity of bolus of the lesion and immobilization as well as the proximity to neighboring critical organs using the VMAT-SIB technique. METHODSFive different VMAT-SIB schemes were designed using the Varian Trilogy IX linear accelerator (Varian Medical Systems) for total scalp irradiation and bilateral neck irradiation. These different VMAT scehemes were compared with respect to a dose volume histogram of obtained data, homogeneity, indices, conformity index, OAR, and doses of target volumes. RESULTSThe patient-designed bolus plan 1 with two isocenters was chosen as the most appropriate plan. Plans 2, 3, 4, and 5 were inappropriate plans because the application of the virtual bolus in plan 2 was difficult, plan 3 with one isocenter was unacceptable with respect to the value of conformity index, plan 4 with three isocenters had a matching field, and plan 5 in which different priority values were used had an increase in OAR doses. CONCLUSIONVMAT-SIB can be preferred as an appropriate radiotherapy technique as it can provide optimum and allowable OAR doses in tumors requiring an intensive treatment planning effort.

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Section: Discussionmentioning

confidence: 99%

Total Scalp Irradiation: The Comparison of Five Different Plans Using Volumetric Modulated Arc Therapy- Simultaneous Integrated Boost (VMAT-SIB) Technique

Rakıcı¹

2017

TJ Oncol

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“…Hem foton alanında hem de elektron alanındaki yüzey dozlarını arttırmak için 0,5 cm'lik bolus kullanılır. Teknolojik gelişmeler doğrultusunda birçok merkezde 3 boyutlu konformal radyoterapinin yerini yoğunluk ayarlı radyoterapi (YART) ve görüntü kılavuzluğunda radyoterapi (GKRT) almış olup, bu teknolojik radyoterapi yöntemleri ile hedefte daha homojen bir doz dağılımı elde edilebilmiştir (9)(10)(11) . Görüntü kılavuzluğunda radyoterapi seçenekleri arasında yer alan volümetrik ark tedavisi (VMAT) ve helikal tomoterapi (HT) karşılaştırıldığında HT'nin dozimetrik olarak üstünlüğü gösterilmiştir (12) .…”

Section: Discussionunclassified

Palliative Total Scalp Irradiation Technique in Patient with Widespread Scalp Involvement of Angiosarcoma: Case Report

Özen¹,

Duruer²,

Şanlısoy³

et al. 2015

Terh

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ÖZETTüm skalp ışınlaması (TSI) yaygın skalp tutulumu yapabilen tümöre sahip hastalarda sıklıkla palyatif amaçlı kullanılmaktadır. Tüm skalpte tedavi edici dozun homojen bir şekilde dağılımı ile birlikte beyin ve diğer risk altındaki organların korunabilmesi TSI'ın hem planlanma hem de uygulamasındaki önemli teknik zorluklardır. Yıllar içerisinde tedavi modalitelerindeki teknolojik gelişmeler doğrultusunda TSI'nda farklı teknikler tanımlanmıştır. Fakat üst teknolojilere sahip olmayan tedavi merkezleri için çok fazla farklı seçenek bulunmamaktadır. Bu makalemizde yaygın skalp tutulumu olan 88 yaşında anjiyosarkom tanılı erkek hastamıza palyatif amaçlı (45 Gy/15 fr) uyguladığımız TSI tekniğini (karşılıklı 2 foton ve karşılıklı 2 elektron alanı kombinasyonu) ve tedavi sonuçlarını sunmayı amaçladık.Anahtar kelimeler: Anjiyosarkom, tüm skalp ışınlaması, palyatif tedavi ABSTRACT Total scalp irradiation (TSI) is often used for palliation in patients with tumors which may cause widespread scalp involvement. Protection of brain and other organs at risk with homogenous distribution of therapeutic dose through the whole scalp are technical challenges in planning and application of TSI. In accordance with technological developments, different TSI techniques have been described over the years. But, there are not a lot of different options for cancer centers without advanced technology. In this paper, we aimed to report TSI technique (combination 2 opposite photon fields and 2 opposite electron fields) for palliative intent (45 Gy/15 fr) and treatment results in a 88 years-old male angiosarcoma patient with whole scalp involvement.

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“…Radiotherapeutic approaches to treat the entire scalp range from electron-based over photon-based to combined techniques including intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT), tomotherapy and high dose rate (HDR) brachytherapy [2-5]. …”

Section: Introductionmentioning

confidence: 99%

Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in total scalp irradiation: a single institutional experience

et al. 2016

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PurposeTotal scalp irradiation (TSI) is a rare but challenging indication. We previously reported that non-coplanar intensity-modulated radiotherapy (IMRT) was superior to coplanar IMRT in organ-at-risk (OAR) protection and target dose distribution. This consecutive treatment planning study compared IMRT with volumetric-modulated arc therapy (VMAT).Materials and MethodsA retrospective treatment plan databank search was performed and 5 patient cases were randomly selected. Cranial imaging was restored from the initial planning computed tomography (CT) and target volumes and OAR were redelineated. For each patients, three treatment plans were calculated (coplanar/non-coplanar IMRT, VMAT; prescribed dose 50 Gy, single dose 2 Gy). Conformity, homogeneity and dose volume histograms were used for plan.ResultsVMAT featured the lowest monitor units and the sharpest dose gradient (1.6 Gy/mm). Planning target volume (PTV) coverage and homogeneity was better in VMAT (coverage, 0.95; homogeneity index [HI], 0.118) compared to IMRT (coverage, 0.94; HI, 0.119) but coplanar IMRT produced the most conformal plans (conformity index [CI], 0.43). Minimum PTV dose range was 66.8% –88.4% in coplanar, 77.5%–88.2% in non-coplanar IMRT and 82.8%–90.3% in VMAT. Mean dose to the brain, brain stem, optic system (maximum dose) and lenses were 18.6, 13.2, 9.1, and 5.2 Gy for VMAT, 21.9, 13.4, 14.5, and 6.3 Gy for non-coplanar and 22.8, 16.5, 11.5, and 5.9 Gy for coplanar IMRT. Maximum optic chiasm dose was 7.7, 8.4, and 11.1 Gy (non-coplanar IMRT, VMAT, and coplanar IMRT).ConclusionTarget coverage, homogeneity and OAR protection, was slightly superior in VMAT plans which also produced the sharpest dose gradient towards healthy tissue.

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Total scalp radiation using image-guided IMRT for progressive cutaneous T cell lymphoma

Cited by 19 publications

References 12 publications

Total Scalp Irradiation: The Comparison of Five Different Plans Using Volumetric Modulated Arc Therapy- Simultaneous Integrated Boost (VMAT-SIB) Technique

Total Scalp Irradiation: The Comparison of Five Different Plans Using Volumetric Modulated Arc Therapy- Simultaneous Integrated Boost (VMAT-SIB) Technique

Palliative Total Scalp Irradiation Technique in Patient with Widespread Scalp Involvement of Angiosarcoma: Case Report

Dosimetric comparison of intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) in total scalp irradiation: a single institutional experience

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