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Dosimetric evaluation of multi-pattern spatially fractionated radiation therapy using a multi-leaf collimator and

Sotirios Stathakis1, Carlos Esquivel, Alonso N Gutiérrez

  • 1Department of Radiation Oncology, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA. stathakis@uthscsa.edu

Applied Radiation and Isotopes : Including Data, Instrumentation and Methods for Use in Agriculture, Industry and Medicine
|July 28, 2009
PubMed
Summary

Multi-leaf collimator (MLC) technology enables spatially fractionated radiation therapy (GRID) delivery for large tumors. While accurate for dose calculation, MLC-GRID therapy increases treatment time and surface dose.

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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Area of Science:

  • Radiation Oncology
  • Medical Physics

Background:

  • Spatially fractionated radiation therapy (GRID) offers potential benefits for treating large solid tumors.
  • Traditional GRID delivery methods have limitations.

Purpose of the Study:

  • To present and dosimetrically characterize an alternative GRID therapy delivery technique using multi-leaf collimator (MLC) shaped fields.
  • To evaluate the feasibility of generating various GRID patterns with MLCs for large tumor treatment.

Main Methods:

  • MLC was used to create GRID fields with varying open-to-blocked area ratios and opening separations.
  • Dose distributions were calculated using Pinnacle(3) treatment planning system in a water phantom.
  • Ionization chamber and film measurements were performed in a SolidWater phantom to validate dose characteristics.

Main Results:

  • Pinnacle(3) TPS accurately predicted dose distributions within 5% for most GRID patterns compared to measurements.
  • Discrepancies up to 15% were noted at high photon energies (18MV) with small GRID openings.
  • Skin dose at GRID openings was up to three times higher than open fields, irrespective of the open-to-blocked area ratio.

Conclusions:

  • MLC is a viable tool for delivering spatially fractionated GRID therapy, enabling diverse treatment patterns.
  • Pinnacle(3) TPS demonstrates good accuracy in calculating MLC-based GRID doses.
  • MLC-GRID therapy is associated with extended treatment durations and elevated surface doses.