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A Feasibility Study of a Tilted Head Position in Helical Tomotherapy for Fractionated Stereotactic Radiotherapy of Intracranial Malignancies

Authors
 Yoonsun Chung  ;  Hong In Yoon  ;  Jin Sook Ha  ;  Seijoon Kim  ;  Ik Jae Lee 
Citation
 TECHNOLOGY IN CANCER RESEARCH & TREATMENT, Vol.14(4) : 475-482, 2015 
Journal Title
TECHNOLOGY IN CANCER RESEARCH & TREATMENT
ISSN
 1533-0346 
Issue Date
2015
MeSH
Brain Neoplasms/radiotherapy* ; Dose Fractionation* ; Feasibility Studies ; Head-Down Tilt* ; Humans ; Male ; Radiometry ; Radiosurgery*/methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated*/methods
Keywords
Fractionated stereotactic radiotherapy ; Helical tomotherapy ; Intracranial tumors ; Patient positioning
Abstract
Herein, we evaluated the feasibility of placing patients in a tilted head position as part of routine clinical practice for fractionated stereotactic radiotherapy (FSRT) of intracranial tumors using helical tomotherapy (HT), by assessing its dosimetric benefit and setup accuracy. We reviewed treatment plans of four cases that were to receive FSRT for brain lesions in normal and head-tilted positions. These patients underwent two computed tomography (CT) scans: first in the normal supine position and then in the supine position with the head tilted at a 458 angle. Two separate HT plans for each position were generated in these four patients, using the same planning parameters. Plans were compared for target conformity and dose homogeneity. Maximum and average doses to critical organs, including normal brain, brain stem, optic chiasm, optic nerves, and the eyes, were considered. To evaluate setup accuracy, patient movement during treatment was assessed by post-treatment megavoltage CT scans. Both HT plans achieved similar conformal and homogeneous dose coverage to the target. Head-tilted HT delivered lower average and maximum doses to critical organs in the cases where the tumor was located on the same plane with critical organs, particularly when they were not directly attached. Placement in the head-tilted position without a mouthpiece allowed for increased patient movement during treatment, while use of a mouthpiece reduced patient movement to even less than that observed for normal setup in the supine position. This pilot study showed that placement in a tilted head position for FSRT of intracranial tumors using HT may be of clinical use, but depends on the tumor location.
Full Text
http://tct.sagepub.com/content/14/4/475.abstract
DOI
10.1177/1533034614500420
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140932
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