Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations

Radiation Oncology

Marta Scorsetti¹  Luca Cozzi²  Piera Navarria¹  Antonella Fogliata²  Francesca Lobefalo¹  Angelo Tozzi¹  Stefano Arcangeli¹  Chiara Pellegrini¹  Filippo Alongi¹  Maddalena Catalano¹  Giacomo Reggiori¹  Simona Castiglioni¹  Pietro Mancosu¹ 

[1] IRCCS Istituto Clinico Humanitas, Rozzano (Milano), Italy;Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

关键词: TrueBeam;    RapidArc;    flattening filter free;    liver;    SBRT;   

Others  :  1160900
DOI  :  10.1186/1748-717X-7-16

 received in 2011-12-30, accepted in 2012-02-01,  发布年份 2012

【 摘 要 】

Purpose

To report the initial institute experience in terms of dosimetric and technical aspects in stereotactic body radiation therapy (SBRT) delivered using flattening filter free (FFF) beam in patients with liver lesions.

Methods and Materials

From October 2010 to September 2011, 55 consecutive patients with 73 primary or metastatic hepatic lesions were treated with SBRT on TrueBeam using FFF beam and RapidArc technique. Clinical target volume (CTV) was defined on multi-phase CT scans, PET/CT, MRI, and 4D-CT. Dose prescription was 75 Gy in 3 fractions to planning target volume (PTV). Constraints for organs at risk were: 700 cc of liver free from the 15 Gy isodose, D_max < 21 Gy for stomach and duodenum, D_max < 30 Gy for heart, D_{0.1 cc} < 18 Gy for spinal cord, V_{15 Gy} < 35% for kidneys. The dose was downscaled in cases of not full achievement of dose constraints. Daily cone beam CT (CBCT) was performed.

Results

Forty-three patients with a single lesion, nine with two lesions and three with three lesions were treated with this protocol. Target and organs at risk objectives were met for all patients. Mean delivery time was 2.8 ± 1.0 min. Pre-treatment plan verification resulted in a Gamma Agreement Index of 98.6 ± 0.8%. Mean on-line co-registration shift of the daily CBCT to the simulation CT were: -0.08, 0.05 and -0.02 cm with standard deviations of 0.33, 0.39 and 0.55 cm in, vertical, longitudinal and lateral directions respectively.

Conclusions

SBRT for liver targets delivered by means of FFF resulted to be feasible with short beam on time.

【 授权许可】

   
2012 Mancosu et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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