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UNIVERSITY OF BUCHAREST
FACULTY OF PHYSICS Guest
2024-11-23 18:12 |
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Conference: Bucharest University Faculty of Physics 2023 Meeting
Section: Biophysics; Medical Physics
Title:
Sparing of the hippocampus during whole brain radiation therapy: A dosimetric study using Monaco treatment planning system
Authors:
Maria-Silvia STANA(1), Răducu POPA(2), Marius CĂLIN(1)
Affiliation:
1)University of Bucharest, Faculty of Physics, 405 Atomistilor Street, P.O. Box MG-11, 077125 Magurele, Romania
2)MedEuropa Bucharest - Radiotherapy and Medical Oncology, Dobroesti Road, Bucharest, Romania
E-mail
maria.stana@s.unibuc.ro
Keywords:
Magnetic resonance imaging, computed tomography, radiotherapy, medical physicist
Abstract:
High energy X-rays radiotherapy is a common treatment for brain tumours. There are different types of external radiotherapy. The most common type used is called volumetric modulated arc therapy (VMAT).
The goal of this treatment was to perform whole brain irradiation (WBI) with hippocampus sparing and dose escalation on multiple brain metastases because the irradiation of the hippocampus is the most important cause of neurocognitive decline after cerebral radiotherapy.
The treatment plan for brain cancer patients is a complex and customized process that aims to provide the best therapeutic options based on the characteristics of each patient.
The goals of the radiation treatment planning were homogeneous whole brain dose distribution, maximal hippocampus sparing, highly conformal dose escalation to brain metastases, and protection of predefined organs at risk (OAR) like brainstem, optical chiasm and optical nerves, eyes, inner ears, and lenses.
For radiation treatment planning, patients underwent computed tomography (CT) in thermoplastic mask immobilization. Contrast-enhanced T1-weighted magnetic resonance imaging scans for treatment planning and CT images were rigidly coregistered based on mutual information in the contouring system (Monaco version 6.1, Elekta) and served for target volume and OAR delineation and dose calculation.
The hippocampus sparing plan was considered clinically acceptable per RTOG 0933 dosimetry compliance criteria. VMAT planning provided highly conformal and homogenous dose distributions for the whole brain with lower doses to OAR such as the hippocampus. These results suggest that HS-WBRT with SIB is a clinically feasible, fast, and effective treatment option for patients with a relatively large number of m-BM lesions.
References:
Podgorsak E. B. , Radiation Oncology Physics: A Handbook for Teachers and Students,INTERNATIONAL ATOMIC ENERGY AGENCY, VIENNA, 2005
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