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Clinical outcomes of multileaf collimator-based CyberKnife for spine stereotactic body radiation therapy

 Nalee Kim  ;  Ho Lee  ;  Jin Sung Kim  ;  Jong Geal Baek  ;  Chang Geol Lee  ;  Sei Kyung Chang  ;  Woong Sub Koom 
 BRITISH JOURNAL OF RADIOLOGY, Vol.90(1079) : 20170523, 2017 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cancer Pain/radiotherapy ; Feasibility Studies ; Female ; Gadolinium ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Multimodal Imaging/methods ; Radiosurgery/instrumentation* ; Radiosurgery/methods* ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Retrospective Studies ; Spinal Neoplasms/diagnostic imaging ; Spinal Neoplasms/pathology ; Spinal Neoplasms/radiotherapy* ; Spinal Neoplasms/secondary* ; Tomography, X-Ray Computed/methods ; Tumor Burden
OBJECTIVE: Stereotactic body radiotherapy (SBRT) for spinal metastases is becoming a prevalent therapeutic option. We aimed to evaluate the clinical feasibility and outcomes of the recently developed multileaf collimator (MLC)-based CyberKnife (CK-M) for spine SBRT.

METHODS: We reviewed 119 patients of 144 cases with 229 lesions treated with CK between November 2014 and March 2016. The lesion features, dosimetric parameters and clinical outcomes were compared between fixed cone collimator based CK (CK-F) and CK-M.

RESULTS: Of 144 cases, 78 and 66 were treated with CK-F and CK-M, respectively. CK-M achieved an adequate target volume coverage that was comparable with CK-F (median 92 vs 90%; p = 0.03) even in larger targets (median 64.2 vs 46.7 cm3; p = 0.01), respectively. CK-M showed an improvement in the gradient index (p < 0.001) and no difference in conformity (p = 0.16). With CK-M, the median beam delivery time was significantly reduced by 30% (to 34 vs 48 min; p < 0.001). CK-M showed 1 year local control rates that were comparable to CK-F (77 vs 78%, respectively; p = 0.83).

CONCLUSION: CK-M exhibits dosimetric data and local control that are comparable with CK-F, but with significant treatment time reduction. CK-M could be widely used in spine SBRT. Advances in knowledge: Given the recently developed MLC in CK, we aimed to evaluate the clinical feasibility and outcomes of MLC compared with fixed cone-based CK. MLC showed equivalent plan quality and significant treatment time reduction with comparable radiological control. We report here MLC as an effective and tolerable treatment option in CK.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Nalee(김나리) ORCID logo https://orcid.org/0000-0003-4742-2772
Kim, Jinsung(김진성) ORCID logo https://orcid.org/0000-0003-1415-6471
Baek, Jong Geal(백종걸)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Lee, Ho(이호) ORCID logo https://orcid.org/0000-0001-5773-6893
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