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  • Dosimetric investigation of...
    Shirata, Ryosuke; Inoue, Tatsuya; Sugimoto, Satoru; Saito, Anneyuko I; Omura, Motoko; Minagawa, Yumiko; Sasai, Keisuke

    BJR open, 08/2023, Letnik: 5, Številka: 1
    Journal Article

    Intensity-modulated radiotherapy (IMRT) is a well-established radiotherapy technique for delivering radiation to cancer with high conformity while sparing the surrounding normal tissue. Two main purposes of this study are: (1) to investigate dose calculation accuracy of helical IMRT (HIMRT) and volumetric-modulated arc therapy (VMAT) on surface region and (2) to evaluate the dosimetric efficacy of HIMRT and VMAT for scalp-sparing in whole brain radiotherapy (WBRT). First, using a radiochromic film and water-equivalent phantom with three types of boluses (1, 3, 5 mm), calculation/measurement dose agreement at the surface region in the VMAT and HIMRT plans were examined. Then, HIMRT, 6MV-VMAT and 10MV-VMAT with scalp-sparing, and two conventional three-dimensional conformal radiotherapy plans (6MV-3DCRT and 10MV-3DCRT; as reference data) were created for 30 patients with brain metastasis (30 Gy/10 fractions). The mean dose to the scalp and the scalp volume receiving 24 and 30 Gy were compared. The percentage dose differences between the calculation and measurement were within 7%, except for the HIMRT plan at a depth of 1 mm. The averaged mean scalp doses Gy, V24Gy %, and V30Gy % (1SD) for 6MV-3DCRT, 10MV-3DCRT, HIMRT, 6MV-VMAT, and 10MV-VMAT were 26.6 (1.1), 86.4 (7.3), 13.2 (4.2), 25.4 (1.0), 77.8 (7.5), 13.2 (4.2), 23.2 (1.5), 42.8 (19.2), 0.2 (0.5), 23.6 (1.6), 47.5 (17.9), 1.2 (1.8), and 22.7 (1.7), 36.4 (17.6), 0.7 (1.1), respectively. Regarding the dose parameters, HIMRT achieved a lower scalp dose compared with 6MV-VMAT. However, the highest ability to reduce the mean scalp dose was showed in 10MV-VMAT. Scalp-sparing WBRT using HIMRT or VMAT may prevent radiation-induced alopecia in patients with BM.