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[Modern three-dimensional conformal craniospinal radiotherapy].

Zsolt Sebestyén1, Péter Kovács, Akos Gulybán

  • 1Onkoterápiás Intézet, Pécsi Tudományegyetem, ÁOK KK, Pécs, Hungary. zsolt.sebestyen@aok.pte.hu

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Summary

This study optimized craniospinal irradiation (CSI) field matching using a multisegmental technique. This precise technique reduces overdosed regions, improving radiation therapy for long target volumes.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Cancer Treatment

Context:

  • Craniospinal irradiation (CSI) presents challenges in precise field matching for optimal dose delivery to the planning target volume (PTV).
  • Accurate alignment of radiation beams is crucial for effective cancer treatment, especially for extended target volumes.
  • Previous methods lacked sufficient precision in managing overlapping radiation fields.

Purpose:

  • To evaluate a CT-based, 3D-planned conformal CSI technique using a multisegmental approach for improved field matching.
  • To ensure optimal dose coverage of the planning target volume (PTV) while minimizing irradiated healthy tissues.
  • To validate the precision and efficacy of the implemented field matching technique.

Summary:

  • Eight patients underwent CT-based, 3D-planned conformal CSI with immobilization in the prone position.
  • A multisegmental technique with specific offsets was employed to eliminate overlapping regions at junction field edges.
  • Dose prescription was 36 Gy at 1.8 Gy per fraction, with PTV coverage of at least 95% (ICRU 50, 62).
  • Field matching strategies were adapted based on patient anatomy and PTV length, sometimes utilizing increased source-to-skin distance (SSD).

Impact:

  • The multisegmental technique with adjusted offsets successfully minimized overdosed regions at field junctions.
  • Phantom verification confirmed the precision of field matching, enhancing patient positioning accuracy.
  • This approach improves radiation biological outcomes by reducing the risk of radiation-induced toxicity.