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Strahlentherapie und Onkologie

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01-10-2018 | Original Article

Stereotactic radiotherapy for choroidal melanomas by means of HybridArc™

Physics and technique of linac-based photon beam therapy

Authors: Dr.-Ing. Markus Wösle, M. Sc., Lothar Krause, Shanthala Sreenivasa, Dirk Vordermark, Ilja F. Ciernik

Published in: Strahlentherapie und Onkologie | Issue 10/2018

Abstract

Purpose

Stereotactic radiotherapy (SRT) is suitable to treat ocular tumours. The optimal beam geometry for SRT, however, has not been defined. Here we evaluate a combination technique with dynamic conformal arcs (DCAs) and intensity-modulated static fields (IMRT), known as HybridArc™ (HA).

Methods

For the first consecutive 25 cases with choroidal melanomas with volumes of 0.02 to 1.18 cm³ treated with 50 Gy in five fractions, the results with respect to dose conformity, homogeneity, and dose distributions were summarised. To describe the dose distribution at the planning target volume (PTV) boundary, we defined a spatially averaged dose gradient (SADG) and compared it with Paddick’s gradient index (GI). We made dosimetric comparisons between HA and other irradiation techniques.

Results

The PTVs ranged from 0.42 to 3.37 cm³. The conformity index (CI) was 1.25 ± 0.15, and the homogeneity index (HI) 0.08 ± 0.02. The SADG was (−3.5 ± 0.5) Gy/mm or (−7.0 ± 1.0) %/mm between the isodose levels 95 and 20%; local minima reached −11.5 Gy/mm or −22.9%/mm. The coefficient of determination for a nonlinear regression of GI on SADG was 0.072. After a median follow-up time of 19.6 months, local tumour control was 100% without any case of post-therapeutic enucleation. Two patients (8%) developed liver metastases.

Conclusion

SRT of ocular tumours by HA is highly appropriate, and HA is superior to intensity-modulated arc therapy (IMAT) concerning dose reduction in organs at risk (OARs). The novel gradient measure SADG is more informative than Paddick’s GI.

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Title: Stereotactic radiotherapy for choroidal melanomas by means of HybridArc™
Physics and technique of linac-based photon beam therapy
Authors: Dr.-Ing. Markus Wösle, M. Sc.
Lothar Krause
Shanthala Sreenivasa
Dirk Vordermark
Ilja F. Ciernik
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 10/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1349-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Stereotactic radiotherapy for choroidal melanomas by means of HybridArc™

Physics and technique of linac-based photon beam therapy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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