Verification techniques and dose distribution for computed tomographic planned supine craniospinal radiation therapy

Chang, Eric L.; Wong, Pei Fong; Forster, Kenneth; Petru, Mark D; Kowalski, Alexander; Maor, Moshe

doi:10.1016/s0958-3947(02)00248-0

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…An overdosage of up to 40% in consistently applied 5-mm overlap was found [17]. Dosimetry of supine treatment with a single extended distance spinal field revealed a dose range of 89.3-108% at the junction [3]. Without a daily check, a craniospinal junction error of 0.5 mm (± 5.4) underlap was reported.…”

Section: Resultsmentioning

confidence: 99%

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Craniospinal Radiotherapy in an Advanced Technique

et al. 2008

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Section: Resultsmentioning

confidence: 99%

“…A well-established technique in prone position has been measured long time ago for dose inhomogeneities in detail [22]. Several reports with immobilization in supine position have been published [3,5,11,13,15,18]. Our idea was to enlarge SSD to get beam sizes capable of covering the whole spinal axis.…”

Section: Introductionmentioning

confidence: 99%

Craniospinal Radiotherapy in an Advanced Technique

et al. 2008

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“…and spinal-spinal fields is a concern for supine positioning because visualization of the light field on the patient is no longer applicable. Chang et al 9) described 2 verification techniques for the supine position. Daily verification required placement of a wire over the patient's chin to mark the inferior border of the light field from the cranial field, followed by a PA portal image of the spinal field to verify the approximate gap at the craniospinal junction, which was planned at 0.3 cm separation.…”

Section: Verification Of the Field Junction Between Craniospinal Fieldsmentioning

confidence: 99%

A Smart Setup for Craniospinal Irradiation

et al. 2013

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Our purpose is to present a novel technique for delivering craniospinal irradiation in the supine position using a perfect match, field-in-field (FIF) intrafractional feathering, and simple forward-optimization technique. To achieve this purpose, computed tomography simulation was performed with patients in the supine position. Half-beam, blocked, opposed, lateral, cranial fields with a collimator rotation were matched to the divergence of the superior border of an upper-spinal field. Fixed field parameters were used, and the isocenter of the upper-spinal field was placed at the same source-to-axis distance (SAD), 20 cm inferior to the cranial isocenter. For a lower-spinal field, the isocenter was placed 40 cm inferior to the cranial isocenter at a constant SAD. Both gantry and couch rotations for the lower-spinal field were used to achieve perfect divergence match with the inferior border of the upper-spinal field. A FIF technique was used to feather the craniospinal and spinal-spinal junction daily by varying the match line over 2 cm. The dose throughout the target volume was modulated using the FIF simple forward optimization technique to obtain homogenous coverage. Daily, image-guided therapy was used to assure and verify the setup. This supine-position, perfect match craniospinal irradiation technique with FIF intrafractional feathering and dose modulation provides a simple and safe way to deliver treatment while minimizing dose inhomogeneity.

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“…Radiation therapy for patients with head and neck, [1][2][3] craniospinal, 4 and breast cancer 5 commonly use two separate abutting fields. Precise asymmetric jaw junctioning at the central axis of radiation field (half-beam block) is imperative to avoid treatment complications due to substantial overlapping or underlapping of the abutting fields.…”

Section: Introductionmentioning

confidence: 99%