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Stereotactic Radiosurgery for Multiple Brain Metastases: A Dose-Volume Study

  • Tanya KairnEmail author
  • Somayeh Zolfaghari
  • Daniel Papworth
  • Mark West
  • David Schlect
  • Scott Crowe
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 68/3)

Abstract

A substantial number of cancer patients develop brain metastases, which often present as multiple lesions. Stereotactic radiosurgery (SRS) can be used to treat brain metastases, with some incidental dose to the healthy brain. This study evaluated the effect of the number and combined volume of metastatic lesions on the dosimetric quality and the deliverability of a small sample of SRS test treatments. Five simulated static conformal arc treatments of 4–12 brain metastases were planned for linac-based multi-isocentre delivery to a head phantom. Film measurements were used to verify dose calculation and treatment delivery accuracy. Several of the treatment plans were considered clinically acceptable when local dose prescriptions (14–18 Gy) were used, but when the prescription dose to all metastases was increased to match the RTOG 0320 recommended value of 24 Gy, no plans resulted in a V12 less than 10 cm3. Agreement between planned and measured dose was poorest for the treatments of 10 and 12 metastases, due to increased disagreement in out-of-field regions. Using the multi-isocentre static conformal arc method, it is possible to deliver treatments to relatively large numbers (at least 12) and total volumes (at least 8 cm3) of brain metastases without excessive radiation doses being delivered to the healthy brain, provided that reduced prescription doses are acceptable.

Keywords

Radiation therapy Dosimetry Stereotactic 

Notes

Compliance with Ethical Standards

The authors declare that they have no conflict of interest. This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Tanya Kairn
    • 1
    • 2
    • 3
    Email author
  • Somayeh Zolfaghari
    • 1
  • Daniel Papworth
    • 2
  • Mark West
    • 2
  • David Schlect
    • 2
  • Scott Crowe
    • 1
    • 3
  1. 1.Queensland University of TechnologyBrisbaneAustralia
  2. 2.Genesis Cancer Care Queensland, Genesis CareBrisbaneAustralia
  3. 3.Royal Brisbane and Women’s HospitalBrisbaneAustralia

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