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Original Article

Korean Journal of Medical Physics 2014; 25(3): 176-184

Published online September 30, 2014

Copyright © Korean Society of Medical Physics.

Comparison of Dose Distribution in Spine Radiosurgery Plans: Simultaneously Integrated Boost and RTOG 0631 Protocol

Su Yeon Park, Dongryul Oh, Hee Chul Park, Jin Sung Kim, Jong Sik Kim, Eun Hyuk Shin, Hye Young Kim, Sang Hoon Jung, Youngyih Han

Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Received: August 18, 2014; Revised: September 17, 2014; Accepted: September 18, 2014

Abstract

In this study, we compareddose distributions from simultaneously integrated boost (SIB) method versus the RTOG 0631 protocol for spine radiosurgery. Spine radiosurgery plans wereperformed in five patients with localized spinal metastases from hepatocellular carcinoma. The computed tomography (CT) and T1- and T2-weighted magnetic resonance imaging (MRI) were fused for delineating of GTV and spinal cord. In SIB plan, the clinical target volume (CTV1) was included the whole compartments of the involved spine, while RTOG 0631 protocol defines the CTV2 as the involved vertebral body and both left and right pedicles. The CTV2 includes transverse process and posterior element according to the extent of GTV. The doses were prescribed 18 Gy to GTV and 10 Gy to CTV1 in SIB plan, while the prescription of RTOG 0631 protocol was applied 18 Gy to CTV2. The results of dose-volume histogram (DVH) showed that there were competitive in target coverage, while the doses of spinal cord andother normal organs were lower in SIB method than in RTOG 0631 protocol. The 85% irradiated volume of VB in RTOG 0631 protocol was similar to that in the SIB plan. However, the dose to normal organs in RTOG 0631 had a tendency to higher than that in SIB plan. The SIB plan might be an alternative method in case of predictive serious complications of surrounded normal organs. In conclusion, although both approaches of SIB or RTOG 0631 showed competitive planning results, tumor control probability (TCP) and normal tissue complication probability (NTCP) through diverse clinical researches should be analyzed in the future.

KeywordsSpinal metastases, Spine radiosurgery, Simultaneously integrated boost, RTOG 0631 protocol

Korean Society of Medical Physics

Vol.35 No.1
March 2024

pISSN 2508-4445
eISSN 2508-4453
Formerly ISSN 1226-5829

Frequency: Quarterly

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