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Helical Tomotherapy-Based STAT RT: Dosimetric Evaluation for Clinical Implementation of a Rapid Radiation Palliation Program

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Title: Helical Tomotherapy-Based STAT RT: Dosimetric Evaluation for Clinical Implementation of a Rapid Radiation Palliation Program
Authors: McIntosh, Alyson1, Dunlap, Neal1, Sheng, Ke1, Geezey, Constance1, Turner, Benton1, Blackhall, Leslie2, Weiss, Geoffrey2, Lappinen, Eric3, Larner, James M.1, Read, Paul W.1 pwr3u@virginia.edu
Source: Medical Dosimetry. Winter2010, Vol. 35 Issue 4, p280-286. 7p.
Subjects: Radiation dosimetry, Tomography, Radiotherapy, Palliative treatment, Lung cancer, Metastasis, Imaging phantoms
Abstract: Abstract: Helical tomotherapy–based STAT radiation therapy (RT) uses an efficient software algorithm for rapid intensity-modulated treatment planning, enabling conformal radiation treatment plans to be generated on megavoltage computed tomography (MVCT) scans for CT simulation, treatment planning, and treatment delivery in one session. We compared helical tomotherapy–based STAT RT dosimetry with standard linac-based 3D conformal plans and standard helical tomotherapy–based intensity-modulated radiation therapy (IMRT) dosimetry for palliative treatments of whole brain, a central obstructive lung mass, multilevel spine disease, and a hip metastasis. Specifically, we compared the conformality, homogeneity, and dose with regional organs at risk (OARs) for each plan as an initial step in the clinical implementation of a STAT RT rapid radiation palliation program. Hypothetical planning target volumes (PTVs) were contoured on an anthropomorphic phantom in the lung, spine, brain, and hip. Treatment plans were created using three planning techniques: 3D conformal on Pinnacle3, helical tomotherapy, and helical tomotherapy–based STAT RT. Plan homogeneity, conformality, and dose to OARs were analyzed and compared. STAT RT and tomotherapy improved conformality indices for spine and lung plans (CI spine = 1.21, 1.17; CI lung = 1.20, 1.07, respectively) in comparison with standard palliative anteroposterior/posteroanterior (AP/PA) treatment plans (CI spine = 7.01, CI lung = 7.30), with better sparing of heart, esophagus, and spinal cord. For palliative whole-brain radiotherapy, STAT RT and tomotherapy reduced maximum and mean doses to the orbits and lens (maximum/mean lens dose: STAT RT = 2.94/2.65 Gy, tomotherapy = 3.13/2.80 Gy, Lateral opposed fields = 7.02/3.65 Gy), with an increased dose to the scalp (mean scalp dose: STAT RT = 16.19 Gy, tomotherapy = 15.61 Gy, lateral opposed fields = 14.01 Gy). For bony metastatic hip lesions, conformality with both tomotherapy techniques (CI = 1.01 each) is superior to AP/PA treatments (CI = 1.21), as expected. Helical tomotherapy–based STAT RT treatment planning provides clinically acceptable dosimetry, with conformality and homogeneity that is superior to standard linac-based 3D conformal planning and is only slightly inferior to standard helical tomotherapy IMRT dosimetry. STAT RT facilitates rapid treatment planning and delivery for palliative radiation of patients with metastatic disease, with relative sparing of adjacent OARs compared with standard 3D conformal plans. [Copyright &y& Elsevier]
Copyright of Medical Dosimetry is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: <searchLink fieldCode="AR" term="%22McIntosh%2C+Alyson%22">McIntosh, Alyson</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Dunlap%2C+Neal%22">Dunlap, Neal</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Sheng%2C+Ke%22">Sheng, Ke</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Geezey%2C+Constance%22">Geezey, Constance</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Turner%2C+Benton%22">Turner, Benton</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Blackhall%2C+Leslie%22">Blackhall, Leslie</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Weiss%2C+Geoffrey%22">Weiss, Geoffrey</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Lappinen%2C+Eric%22">Lappinen, Eric</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Larner%2C+James+M%2E%22">Larner, James M.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Read%2C+Paul+W%2E%22">Read, Paul W.</searchLink><relatesTo>1</relatesTo><i> pwr3u@virginia.edu</i>
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  Data: <searchLink fieldCode="JN" term="%22Medical+Dosimetry%22">Medical Dosimetry</searchLink>. Winter2010, Vol. 35 Issue 4, p280-286. 7p.
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  Data: Abstract: Helical tomotherapy–based STAT radiation therapy (RT) uses an efficient software algorithm for rapid intensity-modulated treatment planning, enabling conformal radiation treatment plans to be generated on megavoltage computed tomography (MVCT) scans for CT simulation, treatment planning, and treatment delivery in one session. We compared helical tomotherapy–based STAT RT dosimetry with standard linac-based 3D conformal plans and standard helical tomotherapy–based intensity-modulated radiation therapy (IMRT) dosimetry for palliative treatments of whole brain, a central obstructive lung mass, multilevel spine disease, and a hip metastasis. Specifically, we compared the conformality, homogeneity, and dose with regional organs at risk (OARs) for each plan as an initial step in the clinical implementation of a STAT RT rapid radiation palliation program. Hypothetical planning target volumes (PTVs) were contoured on an anthropomorphic phantom in the lung, spine, brain, and hip. Treatment plans were created using three planning techniques: 3D conformal on Pinnacle3, helical tomotherapy, and helical tomotherapy–based STAT RT. Plan homogeneity, conformality, and dose to OARs were analyzed and compared. STAT RT and tomotherapy improved conformality indices for spine and lung plans (CI spine = 1.21, 1.17; CI lung = 1.20, 1.07, respectively) in comparison with standard palliative anteroposterior/posteroanterior (AP/PA) treatment plans (CI spine = 7.01, CI lung = 7.30), with better sparing of heart, esophagus, and spinal cord. For palliative whole-brain radiotherapy, STAT RT and tomotherapy reduced maximum and mean doses to the orbits and lens (maximum/mean lens dose: STAT RT = 2.94/2.65 Gy, tomotherapy = 3.13/2.80 Gy, Lateral opposed fields = 7.02/3.65 Gy), with an increased dose to the scalp (mean scalp dose: STAT RT = 16.19 Gy, tomotherapy = 15.61 Gy, lateral opposed fields = 14.01 Gy). For bony metastatic hip lesions, conformality with both tomotherapy techniques (CI = 1.01 each) is superior to AP/PA treatments (CI = 1.21), as expected. Helical tomotherapy–based STAT RT treatment planning provides clinically acceptable dosimetry, with conformality and homogeneity that is superior to standard linac-based 3D conformal planning and is only slightly inferior to standard helical tomotherapy IMRT dosimetry. STAT RT facilitates rapid treatment planning and delivery for palliative radiation of patients with metastatic disease, with relative sparing of adjacent OARs compared with standard 3D conformal plans. [Copyright &y& Elsevier]
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  Data: <i>Copyright of Medical Dosimetry is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1016/j.meddos.2009.09.002
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