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Radiation Oncology
Published in: Radiation Oncology 1/2011

Open Access 01-12-2011 | Research

Peripheral doses in patients undergoing Cyberknife treatment for intracranial lesions. A single centre experience

Authors: Vassiliki Vlachopoulou, Christos Antypas, Harry Delis, Argyrios Tzouras, Nikolaos Salvaras, Dimitrios Kardamakis, George Panayiotakis

Published in: Radiation Oncology | Issue 1/2011

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Abstract

Background

Stereotactic radiosurgery/radiotherapy procedures are known to deliver a very high dose per fraction, and thus, the corresponding peripheral dose could be a limiting factor for the long term surviving patients. The aim of this clinical study was to measure the peripheral dose delivered to patients undergoing intracranial Cyberknife treatment, using the MOSFET dosimeters. The influence of the supplemental shielding, the number of monitor units and the collimator size to the peripheral dose were investigated.

Methods

MOSFET dosimeters were placed in preselected anatomical regions of the patient undergoing Cyberknife treatment, namely the thyroid gland, the nipple, the umbilicus and the pubic symphysis.

Results

The mean peripheral doses before the supplemental shielding was added to the Cyberknife unit were 51.79 cGy, 13.31 cGy and 10.07 cGy while after the shielding upgrade they were 38.40 cGy, 10.94 cGy, and 8.69 cGy, in the thyroid gland, the umbilicus and the pubic symphysis, respectively. The increase of the collimator size corresponds to an increase of the PD and becomes less significant at larger distances, indicating that at these distances the PD is predominate due to the head leakage and collimator scatter.

Conclusion

Weighting the effect of the number of monitor units and the collimator size can be effectively used during the optimization procedure in order to choose the most suitable treatment plan that will deliver the maximum dose to the tumor, while being compatible with the dose constraints for the surrounding organs at risk. Attention is required in defining the thyroid gland as a structure of avoidance in the treatment plan especially in patients with benign diseases.
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Literature
1.
Xu XG, Bednarz B, Paganetti H: A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction. Phys Med Biol 2008,53(13):R193-R241. 10.1088/0031-9155/53/13/R01PubMedCentralCrossRefPubMed
2.
Brenner DJ, Doll R, Goodhead DT, Hall EJ, Land CE, Little JB, Lubin JH, Preston DL, Preston RJ, Puskin JS, Ron E, Sachs RK, Samet JM, Setlow RB, Zaider M: Cancer risks attributable to low doses of ionizing radiation: Assessing what we really know. Proceedings of the National Academy of Sciences of the United States of America 2003,100(24):13761-13766. 10.1073/pnas.2235592100PubMedCentralCrossRefPubMed
3.
Acun H, Kemikler G, Karadeniz A: Dosimetric analysis of thyroid doses from total cranial irradiation. Radiat Prot Dosimetry 2007,123(4):498-504.CrossRefPubMed
4.
Somerville HM, Steinbeck KS, Stevens G, Delbridge LW, Lam AH, Stevens MM: Thyroid neoplasia following irradiation in adolescent and young adult survivors of childhood cancer. Med J Aust 2002,176(12):584-587.PubMed
5.
Antypas C, Pantelis Ε: Performance evaluation of a CyberKnife ® G4 image-guided robotic stereotactic radiosurgery system. Phys Med Biol 2008, 53: 4697-4718. 10.1088/0031-9155/53/17/016CrossRefPubMed
6.
Murphy MJ: Fiducial-based targeting accuracy for external-beam radiotherapy. Med Phys 2002,29(3):334-344. 10.1118/1.1448823CrossRefPubMed
7.
Fu D, Kuduvalli G, Mitrovic V, Main W, Thomson L: Automated skull tracking for the CyberKnife ® image-guided radiosurgery system. Progress in Biomedical Optics and Imaging - Proceedings of SPIE 2005,5744(1):366-377.
8.
Ho AK, Fu D, Cotrutz C, Hancock SL, Chang SD, Gibbs IC, Maurer CR Jr, Adler JR Jr: A study of the accuracy of cyberknife spinal radiosurgery using skeletal structure tracking. Neurosurgery 2007,60(2 Suppl 1):147-156.
9.
Collins SP, Coppa ND, Zhang Y, Collins BT, McRae DA, Jean WC: CyberKnife ® radiosurgery in the treatment of complex skull base tumors: analysis of treatment planning parameters. Radiat Oncol 2006,1(1):46. 10.1186/1748-717X-1-46PubMedCentralCrossRefPubMed
10.
Zytkovicz A, Daftari I, Phillips TL, Chuang CF, Verhey L, Petti PL: Peripheral dose in ocular treatments with CyberKnife and Gamma Knife radiosurgery compared to proton radiotherapy. Phys Med Biol 2007,52(19):5957-5971. 10.1088/0031-9155/52/19/016CrossRefPubMed
11.
Petti PL, Chuang CF, Smith V, Larson DA: Peripheral doses in Cyberknife radiosurgery. Med Phys 2006,33(6):1770-1779. 10.1118/1.2198173CrossRefPubMed
12.
Chuang CF, Larson DA, Zytkovicz A, Smith V, Petti PL: Peripheral dose measurement for CyberKnife radiosurgery with upgraded linac shielding. Med Phys 2008,35(4):1494-1496. 10.1118/1.2889620CrossRefPubMed
13.
Di Betta E, Fariselli L, Bergantin A, Locatelli F, Del Vecchio A, Broggi S, Fumagalli ML: Evaluation of the peripheral dose in stereotactic radiotherapy and radiosurgery treatments. Med Phys 2010,37(7):3587-3594. 10.1118/1.3447724PubMedCentralCrossRefPubMed
14.
Yu C, Luxton G, Apuzzo ML, MacPherson DM, Petrovich Z: Extracranial radiation doses in patients undergoing gamma knife radiosurgery. Neurosurgery 1997,41(3):553-559.PubMed
15.
Vlachopoulou V, Malatara G, Delis H, Theodorou K, Kardamakis D, Panayiotakis G: Peripheral dose measurement in high-energy photon radiotherapy with the implementation of MOSFET. World J Radiol 2010,2(11):434-439. 10.4329/wjr.v2.i11.434PubMedCentralCrossRefPubMed
16.
Consorti R, Petrucci A, Fortunato F, Soriani A, Marzi S, Iaccarino G, Landoni V, Benassi M: In vivo dosimetry with MOSFETs: Dosimetric characterization and first clinical results in intraoperative radiotherapy. Int J Radiat Oncol Biol Phys 2005,63(3):952-960. 10.1016/j.ijrobp.2005.02.049CrossRefPubMed
17.
Rosenfeld AB: MOSFET Dosimetry on Modern Radiation Oncology Modalities. Radiat Prot Dosimetry 2002, 101: 393-398.CrossRefPubMed
18.
Cheung T, Yu PKN, Butson MJ: Low-dose measurement with a MOSFET in high-energy radiotherapy applications. Radiat Meas 2005,39(1):91-94. 10.1016/j.radmeas.2004.04.007CrossRef
19.
Ramani R, Russell S, O'Brien P: Clinical dosimetry using mosfets. Int J Radiat Oncol Biol Phys 1997,37(4):959-964. 10.1016/S0360-3016(96)00600-1CrossRefPubMed
20.
Butson MJ, Cheung T, Yu PKN: Peripheral dose measurement with a MOSFET detector. Appl Radiat Isotopes 2005,62(4):631-634. 10.1016/j.apradiso.2004.09.001CrossRef
21.
Butson MJ, Rozenfeld A, Mathur JN, Carolan M, Wong TP, Metcalfe PE: A new radiotherapy surface dose detector: the MOSFET. Med Phys 1996,23(5):655-658. 10.1118/1.597702CrossRefPubMed
22.
Best Medical Canada: Operator's manual for the mobile MOSFET dosimetry system. Ottawa; 2007.
23.
Kilby W, Dooley JR, Kuduvalli G, Sayeh S, Maurer CR Jr: The CyberKnife ® Robotic Radiosurgery System in 2010. Technol Cancer Res Treat 2010,9(5):433-552.CrossRefPubMed
24.
Stovall M, Blackwell CR, Cundiff J, Novack DH, Palta JR, Wagner LK, Webster EW, Shalek RJ: Fetal Dose from radiotherapy with photon beams: Report of AAPM Radiation Therapy Committee Task Group N° 36. Med Phys 1995,22(1):63-82. 10.1118/1.597525CrossRefPubMed
25.
Antypas C, Sandilos P, Kouvaris J, Balafouta E, Karinou E, Kollaros N, Vlahos L: Fetal Dose Evaluation During Breast Cancer Radiotherapy. Int J Radiat Oncol Biol Phys 1998,40(4):995-999. 10.1016/S0360-3016(97)00909-7CrossRefPubMed
26.
International Commission of Radiation Protection (ICRP): The 2007 Recommendations of the International Commission on Radiological Protection. Oxford: Pergamon; 2007.
Metadata
Title
Peripheral doses in patients undergoing Cyberknife treatment for intracranial lesions. A single centre experience
Authors
Vassiliki Vlachopoulou
Christos Antypas
Harry Delis
Argyrios Tzouras
Nikolaos Salvaras
Dimitrios Kardamakis
George Panayiotakis
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2011
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-6-157

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