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- Title
Craniospinal Irradiation With Imrt/Vmat - An Institutional Experience.
- Authors
Arvind, S.; Varghese, Sunitha Susan; Patricia, S.
- Abstract
CRANIOSPINAL IRRADIATION WITH IMRT/VMAT - AN INSTITUTIONAL EXPERIENCE Vinitha T C, Arvind S, SunithaSusan Varghese, Patricia S, Rajesh B, Selvamani B Department of Radiation Therapy Christian Medical College Hospital Vellore Abstract Background: Medulloblastoma is the most common malignant paediatric brain tumor. Maximum surgical resection followed by concurrent chemoradiation and adjuvant chemotherapy is the standard of care. Radiotherapy needs to be delivered to a complex target volume which includes the whole craniospinal axis. This study analyses the dosimetric advantages of intensity modulated radiation therapy (IMRT) and Volumetric modulated arc therapy (VMAT) in patients who received craniospinal irradiation (CSI). Methods: Six patients treated with CSI followed by posterior fossa boost using IMRT (2 patients) and VMAT (4 patients) were identified. The patient details were obtained from treatment planning system and outpatient electronic medical records. The target volume included entire cranium and spinal canal from foramen magnum to S2 to S3 level. Organs at risk (OAR) included eyes, parotids, thyroid, lungs, heart, oesophagus, stomach, bowel, kidneys and gonads. Results: The median duration between surgery and initiation of radiation therapy was 5 weeks (range 4 to 6 weeks). The maximum point dose received in all patients treated with IMRT /VMAT was <115%. The mean volume of each PTV receiving at least 95% of the prescribed dose (V95%) was >98% for all plans. Cribriform plate received 98% to 105% of the prescribed dose. Among the 6 patients, the maximum dose received by spinal cord, brainstem, pituitary and optic apparatus was 41Gy, 38Gy, 38Gy and 38Gy respectively. Mean dose received by oesophagus was 17Gy. Mean dose received by bilateral parotids was less than 24Gy and by bilateral eyes was less than 27Gy. Overall treatment time was 6.4 to 7.2 weeks. Four out of six patients had break during the last week of CSI. One patient developed grade 4 neutropenia in the last week of CSI. Conclusion: IMRT and VMAT technique for CSI has a dosimetric advantage in achieving a homogeneous dose distribution in the target with less OAR doses and better conformity.
- Subjects
VOLUMETRIC-modulated arc therapy; ELECTRONIC health records; SPINAL canal; RADIOTHERAPY; CRIBRIFORM plate
- Publication
Journal of Cancer Research & Therapeutics, 2017, Vol 13, pS263
- ISSN
0973-1482
- Publication type
Article