Whole Brain Radiotherapy Combined with Stereotactic Radiosurgery versus Stereotactic Radiosurgery Alone for Brain Metastases

Adaş, Yasemin Güzle; Yazici, O.; Kekilli, Esra; Akkaş, Ebru Atasever; Karakaya, Ebru; Üçer, Ali Riza; Ertas, Gulcin; Calikoglu, Tamer; Elgin, Yeşim; İnan, Gonca Altınışık; Güney, Yıldız

doi:10.7314/apjcp.2015.16.17.7595

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Regarding radiotherapy, WBRT has been the mainstay for brain metastases treatment, but WBRT causes local damage or necrosis of normal tissue within 1 yr with 100% probability and deterioration of cognitive function resulting in poor quality of life . In contrast, SRS can expose normal tissues to less radiation, preserve neurocognitive function, and minimize radiation‐associated hair loss . Therefore, SRS has received increased attention as a treatment option for brain metastases.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric effect of rotational setup errors in stereotactic radiosurgery with HyperArc for single and multiple brain metastases

Sagawa

Ohira

Ueda

et al. 2019

J Applied Clin Med Phys

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PurposeIn stereotactic radiosurgery (SRS) with single‐isocentric treatments for brain metastases, rotational setup errors may cause considerable dosimetric effects. We assessed the dosimetric effects on HyperArc plans for single and multiple metastases.MethodsFor 29 patients (1–8 brain metastases), HyperArc plans with a prescription dose of 20–24 Gy for a dose that covers 95% (D95%) of the planning target volume (PTV) were retrospectively generated (Ref‐plan). Subsequently, the computed tomography (CT) used for the Ref‐plan and cone‐beam CT acquired during treatments (Rot‐CT) were registered. The HyperArc plans involving rotational setup errors (Rot‐plan) were generated by re‐calculating doses based on the Rot‐CT. The dosimetric parameters between the two plans were compared.ResultsThe dosimetric parameters [D99%, D95%, D1%, homogeneity index, and conformity index (CI)] for the single‐metastasis cases were comparable (P > 0.05), whereas the D95% for each PTV of the Rot‐plan decreased 10.8% on average, and the CI of the Rot‐plan was also significantly lower than that of the Ref‐plan (Ref‐plan vs Rot‐plan, 0.93 ± 0.02 vs 0.75 ± 0.14, P < 0.01) for the multiple‐metastases cases. In addition, for the multiple‐metastases cases, the Rot‐plan resulted in significantly higher V10Gy (P = 0.01), V12Gy (P = 0.02), V14Gy (P = 0.02), and V16Gy (P < 0.01) than those in the Ref‐plan.ConclusionThe rotational setup errors for multiple brain metastases cases caused non‐negligible underdosage for PTV and significant increases of V10Gy to V16Gy in SRS with HyperArc.

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Section: Introductionmentioning

confidence: 99%

Dosimetric effect of rotational setup errors in stereotactic radiosurgery with HyperArc for single and multiple brain metastases

Sagawa

Ohira

Ueda

et al. 2019

J Applied Clin Med Phys

View full text Add to dashboard Cite

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“…1 , 2 Several studies have demonstrated that SRS can deliver less radiation to normal brain tissue and better preserve cognitive function than conventional solutions. 3 , 4 , 5 Volumetric modulated arc therapy (VMAT)‐based SRS with a single isocenter allows delivering doses to multiple targets simultaneously while minimizing the dose to surrounding normal tissues. 6 , 7 , 8 , 9 , 10 In particular, newer VMAT‐based SRS solutions with a single isocenter, HyperArc (Varian Medical Systems, Palo Alto, CA), can provide a steeper dose gradient for targets with a lower workload than conventional VMAT‐based SRS.…”

Section: Introductionmentioning

confidence: 99%

“…Stereotactic radiosurgery (SRS) is a suitable treatment technique to deliver the optimal dose distribution for brain metastasis radiotherapy 1,2 . Several studies have demonstrated that SRS can deliver less radiation to normal brain tissue and better preserve cognitive function than conventional solutions 3–5 . Volumetric modulated arc therapy (VMAT)‐based SRS with a single isocenter allows delivering doses to multiple targets simultaneously while minimizing the dose to surrounding normal tissues 6–10 .…”

Section: Introductionmentioning

confidence: 99%

Dosimetric potential of knowledge‐based planning model trained with HyperArc plans for brain metastases

Sagawa

Ueda

Tsuru

et al. 2022

J Applied Clin Med Phys

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Objective Dosimetric potential of knowledge‐based RapidPlan planning model trained with HyperArc plans (Model‐HA) for brain metastases has not been reported. We developed a Model‐HA and compared its performance with that of clinical volumetric modulated arc therapy (VMAT) plans. Methods From 67 clinical stereotactic radiosurgery (SRS) HyperArc plans for brain metastases, 47 plans were used to build and train a Model‐HA. The other 20 clinical HyperArc plans were recalculated in RapidPlan system with Model‐HA. The model performance was validated with the 20 plans by comparing dosimetric parameters for normal brain tissue between clinical plans and model‐generated plans. The 20 clinical conventional VMAT‐based SRS or stereotactic radiotherapy plans (CL‐VMAT) were reoptimized with Model‐HA (RP) and HyperArc system (HA), respectively. The dosimetric parameters were compared among three plans (CL‐VMAT vs. RP vs. HA) in terms of planning target volume (PTV), normal brain excluding PTVs (Brain − PTV), brainstem, chiasm, and both optic nerves. Results In model validation, the optimization performance of Model‐HA was comparable to that of HyperArc system. In comparison to CL‐VMAT, there were no significant differences among three plans with respect to PTV coverage ( p > 0.17) and maximum dose for brainstem, chiasm, and optic nerves ( p > 0.40). RP provided significantly lower V 20 Gy , V 12 Gy , and V 4 Gy for Brain − PTV than CL‐VMAT ( p < 0.01). Conclusion The Model‐HA has the potential to significantly reduce the normal brain dose of the original VMAT plans for brain metastases.

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Validation of frame-based positioning accuracy with cone-beam computed tomography in Gamma Knife Icon radiosurgery

et al. 2018

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Whole Brain Radiotherapy Combined with Stereotactic Radiosurgery versus Stereotactic Radiosurgery Alone for Brain Metastases

Cited by 3 publications

References 12 publications

Dosimetric effect of rotational setup errors in stereotactic radiosurgery with HyperArc for single and multiple brain metastases

Dosimetric effect of rotational setup errors in stereotactic radiosurgery with HyperArc for single and multiple brain metastases

Dosimetric potential of knowledge‐based planning model trained with HyperArc plans for brain metastases

Validation of frame-based positioning accuracy with cone-beam computed tomography in Gamma Knife Icon radiosurgery

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