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Positioning uncertainties in single-target longitudinal segmentation for hippocampal-avoidance whole brain
Chunbo Tang1,2,3, Houjin Zhang4, Longqiu Wu1,2,3
1Department of Oncology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China.
None:
Hippocampal avoidance whole-brain radiotherapy (HA-WBRT) aims to preserve cognitive function during treatment for brain metastases. This study investigated the potential of Single-Target Longitudinal Segmentation Volumetric Modulated Arc Therapy (VMAT) in HA-WBRT, which segments the planning target volume (PTV) into sub-PTVs, using single or dual arcs to generate s-VMAT and d-VMAT strategies. For 20 patients, s-VMAT and d-VMAT achieved lower median Dmean values of 8.3 Gy and 8.1 Gy, and reduced the median Dmax to 13.5 Gy and 12.8 Gy, compared to traditional coplanar/non-coplanar VMAT plans. These strategies showed enhanced robustness but required more monitor units and greater delivery complexity.
