UNIVERSITY OF BUCHAREST
FACULTY OF PHYSICS

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2024-11-24 11:45
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Conference: Bucharest University Faculty of Physics 2021 Meeting


Section: Biophysics; Medical Physics


Title:
Dosimetry analysis on IMRT-VMAT technique in Hippocampal-sparing whole brain irradiation with simultaneous integrated boost for metastatic cancer


Authors:
Andrei ANICA (1,2), Mihai Daniel SUDITU (1), Loredana Elena MILITARU (1,3), Alexandru OPREA (1), Cosmin Marian MIU (1), Alexandru Daniel OLĂRESCU (1,3), Dana Lucia STĂNCULEANU (4)


*
Affiliation:
1) Amethyst Radiation Therapy Center, Bucharest

2) “Carol Davila” University of Medicine and Pharmacy

3) Faculty of Physics, University of Bucharest

4) Institute of Oncology “Alexandru Trestioreanu”, Bucharest



E-mail
suditu.mihai@yahoo.com


Keywords:
radiation therapy, hippocampal-sparing, volumetric modulated arc therapy


Abstract:
Background: Advanced radiotherapy treatment techniques limit the cognitive morbidity associated with whole-brain radiotherapy (WBRT) for brain metastasis through avoidance of hippocampal structures. However, achieving durable intracranial control remains challenging. Methods: We conducted a single-institution single-arm phase I trial of hippocampal-sparing whole brain irradiation with simultaneous integrated boost (HSIB-WBRT) to metastatic deposits in adult patients with brain metastasis. Radiation therapy consisted of intensity-modulated radiation therapy delivering 30 Gy in 10 fractions over 2 weeks to the whole brain with a simultaneous integrated boost of 40 Gy in 10 fractions to metastatic lesions. Hippocampal regions were limited to a maximum dose of 17 Gy. Patients were treated using an Elekta VERSA HD equipped with the Agility™ 160 multileaf collimator for high-speed Results: A total of 29 patients, median age 54 years (interquartile range, 54-65), were enrolled. Mean dose for hippocampus was 9 Gy when the boost was located at a distance greater than 1 cm from hippocampus avoid region and the maximum dose was 16 Gy. For patients with boost < 1 cm from hippocampus avoid region, the dose obtained could not met the dose constraints for hippocampus Conclusions: Hippocampal-sparing whole brain irradiation with simultaneous integrated boost for metastatic cancer is feasible when the boost is administered > 1 cm from hippocampus avoid region. For patients with metastatic lesions < 1 cm from hippocampus avoid region, the dose constraints could not be met.