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Comparison of the extent of hippocampal sparing according to the tilt of a patient's head during WBRT using linear accelerator-based IMRT and VMAT

Authors
Moon, Sun YoungYoon, MyonggeunChung, MijooChung, Weon KuuKim, Dong Wook
Issue Date
5월-2016
Publisher
ELSEVIER SCI LTD
Keywords
Radiation therapy; Whole brain radiotherapy; Hippocampus; Head tilting; Intensity-modulated radiation therapy; Volumetric-modulated arc therapy
Citation
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS, v.32, no.5, pp.657 - 663
Indexed
SCIE
SCOPUS
Journal Title
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS
Volume
32
Number
5
Start Page
657
End Page
663
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/88840
DOI
10.1016/j.ejmp.2016.04.009
ISSN
1120-1797
Abstract
In this paper, we report the results of our investigation into whole brain radiotherapy (WBRT) using linear accelerator-based intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in lung cancer patients with a high risk of metastasis to the brain. Specifically, we assessed the absorbed dose and the rate of adverse effects for several organs at risk (OAR), including the hippocampus, according to the tilt of a patient's head. We arbitrarily selected five cases where measurements were made with the patients' heads tilted forward and five cases without such tilt. We set the entire brain as the planning target volume (PTV), and the hippocampi, the lenses, the eyes, and the cochleae as the main OAR, and formulated new plans for IMRT (coplanar, non-coplanar) and VMAT (coplanar, non-coplanar). Using the dose-volume histogram (DVH), we calculated and compared the effective uniform dose (EUD), normal tissue complication probability (NTCP) of the OAR and the mean and the maximum doses of hippocampus. As a result, if the patient tilted the head forward when receiving the Linac-based treatment, for the same treatment effect in the PTV, we confirmed that a lower dose entered the OAR, such as the hippocampus, eye, lens, and cochlea. Moreover, the damage to the hippocampus was expected to be the least when receiving coplanar VMAT with the head tilted forward. Accordingly, if patients tilt their heads forward when undergoing Linac-based WBRT, we anticipate that a smaller dose would be transmitted to the OAR, resulting in better quality of life following treatment. (C) 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
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보건과학대학 (바이오의공학부)
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