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Spatially fractionated radiotherapy (GRID) using helical tomotherapy.

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Helical tomotherapy GRID (HT-GRID) offers patient-specific treatment for deep-seated tumors, improving dose coverage and sparing normal tissues compared to traditional LINAC-GRID methods.

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Area of Science:

  • Radiation Oncology
  • Medical Physics

Background:

  • Spatially fractionated radiotherapy (GRID) treats large tumors while sparing skin.
  • Deep-seated tumors (> 8 cm) present challenges for adequate dose coverage with conventional LINAC-GRID.
  • Helical tomotherapy GRID (HT-GRID) is a novel approach using patient-specific virtual blocks and IMRT.

Purpose of the Study:

  • To report initial clinical experience with HT-GRID.
  • To compare dosimetric outcomes of HT-GRID versus LINAC-GRID for deep-seated tumors.

Main Methods:

  • Retrospective analysis of 10 patients with deep-seated bulky tumors.
  • Five patients treated with HT-GRID, replanned with LINAC-GRID; five treated with LINAC-GRID, replanned with HT-GRID.
  • Dosimetric parameters: GTV dose (DGTV mean), VPR, normal tissue dose (DNmean), and EUD were evaluated.

Main Results:

  • HT-GRID is patient-specific, adaptable to tumor size/shape, and improves dose coverage for deep-seated tumors.
  • HT-GRID achieved higher DGTV mean, EUD, and VPR compared to LINAC-GRID.
  • HT-GRID resulted in higher DNmean but lower normal tissue EUD, offering better OAR sparing in complex cases.

Conclusions:

  • HT-GRID is a viable, patient-specific alternative for deep-seated tumors inadequately treated by LINAC-GRID.
  • HT-GRID demonstrates superior dosimetric advantages for target coverage and OAR management in complex geometries.