23 February 2016 : Clinical Research
Dose Evaluation of Fractionated Schema and Distance From Tumor to Spinal Cord for Spinal SBRT with Simultaneous Integrated Boost: A Preliminary Study
Hao YangABCDEFG, Bo-ning CaiBC, Xiao-shen WangA, Xiao-hu CongA, Wei XuA, Jin-yuan WangA, Jun YangBC, Shou-ping XuA, Zhong-jian JuA, Lin MaADEFGDOI: 10.12659/MSM.897146
Med Sci Monit 2016; 22:598-607
Abstract
BACKGROUND: This study investigated and quantified the dosimetric impact of the distance from the tumor to the spinal cord and fractionation schemes for patients who received stereotactic body radiation therapy (SBRT) and hypofractionated simultaneous integrated boost (HF-SIB).
MATERIAL AND METHODS: Six modified planning target volumes (PTVs) for 5 patients with spinal metastases were created by artificial uniform extension in the region of PTV adjacent spinal cord with a specified minimum tumor to cord distance (0–5 mm). The prescription dose (biologic equivalent dose, BED) was 70 Gy in different fractionation schemes (1, 3, 5, and 10 fractions). For PTV V100, Dmin, D98, D95, and D1, spinal cord dose, conformity index (CI), V30 were measured and compared.
RESULTS: PTV-to-cord distance influenced PTV V100, Dmin, D98, and D95, and fractionation schemes influenced Dmin and D98, with a significant difference. Distances of ≥2 mm, ≥1 mm, ≥1 mm, and ≥0 mm from PTV to spinal cord meet dose requirements in 1, 3, 5, and 10 fractionations, respectively. Spinal cord dose, CI, and V30 were not impacted by PTV-to-cord distance and fractionation schemes.
CONCLUSIONS: Target volume coverage, Dmin, D98, and D95 were directly correlated with distance from the spinal cord for spine SBRT and HF-SIB. Based on our study, ≥2 mm, ≥1 mm, ≥1 mm, and ≥0 mm distance from PTV to spinal cord meets dose requirements in 1, 3, 5 and 10 fractionations, respectively.
Keywords: Radiosurgery - methods, Dose Fractionation, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Spinal Cord - surgery, Spinal Cord Neoplasms - surgery
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