Background The purpose of this study was to evaluate the efficacy and feasibility of non–coplanar whole brain radiotherapy (NC–WBRT) for parotid sparing.
Methods Fifteen cases, previously treated with WBRT were selected. NC–WBRT plans were generated. The beam arrangement for the non–coplanar plans consisted of superior anterior, right, and left beams. After generation of the non–coplanar plans a field–in–field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC–WBRT plans were subsequently compared with the previously generated bilateral WBRT (B–WBRT) plans. A field–in–field technique was also used with the B–WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.
Results The mean dose to the parotid gland for the two different plans were 16.2 Gy with B–WBRT and 13.7 Gy with NC–WBRT (p<0.05). In the NC–WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p<0.05) than those of the B–WBRT plan. The Dmax of the lens was also lower by 10% with NC–WBRT.
Conclusion The use of NC–WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose–volume parameters of the parotid gland.
Citations
Citations to this article as recorded by
DiffRecon: Diffusion-based CT reconstruction with cross-modal deformable fusion for DR-guided non-coplanar radiotherapy Jiawei Sun, Nannan Cao, Hui Bi, Liugang Gao, Kai Xie, Tao Lin, Jianfeng Sui, Xinye Ni Computers in Biology and Medicine.2024; 179: 108868. CrossRef
Technical note: Feasibility of gating for dynamic trajectory radiotherapy – Mechanical accuracy and dosimetric performance Hannes A. Loebner, Daniel Frauchiger, Silvan Mueller, Gian Guyer, Paul‐Henry Mackeprang, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser, Jenny Bertholet Medical Physics.2023; 50(10): 6535. CrossRef
Impact of the gradient in gantry‐table rotation on dynamic trajectory radiotherapy plan quality Hannes A. Loebner, Silvan Mueller, Werner Volken, Philipp Wallimann, Daniel M. Aebersold, Marco F. M. Stampanoni, Michael K. Fix, Peter Manser Medical Physics.2023; 50(11): 7104. CrossRef
Retrospective analysis of portal dosimetry pre-treatment quality assurance of intracranial SRS/SRT VMAT treatment plans Ernest Osei, Sarah Graves, Johnson Darko Journal of Radiotherapy in Practice.2022; 21(4): 540. CrossRef
Application of piecewise VMAT technique to whole-brain radiotherapy with simultaneous integrated boost for multiple metastases Yuan Xu, Yingjie Xu, Kuo Men, Jianping Xiao, Jianrong Dai Radiation Oncology.2022;[Epub] CrossRef
Setup uncertainties and appropriate setup margins in the head-tilted supine position of whole-brain radiotherapy (WBRT) Jae Won Park, Ji Woon Yea, Jaehyeon Park, Se An Oh, Ngie Min Ung PLOS ONE.2022; 17(8): e0271077. CrossRef
Examination of the best head tilt angle to reduce the parotid gland dose maintaining a safe level of lens dose in whole‐brain radiotherapy using the four‐field box technique Hidetoshi Shimizu, Koji Sasaki, Takahiro Aoyama, Hiroyuki Tachibana, Hiroshi Tanaka, Yutaro Koide, Tohru Iwata, Tomoki Kitagawa, Takeshi Kodaira Journal of Applied Clinical Medical Physics.2021; 22(2): 49. CrossRef
Noncoplanar Versus Coplanar Intensity-Modulated Radiation Therapy (IMRT) for Protection of the Lip and Buccal Mucosa Zheng Lao, Fan Bi, Wenhui Fan, Xuanli Xu, Wenyong Tu, Huifeng Shi Technology in Cancer Research & Treatment.2021; 20: 153303382110195. CrossRef
Whole brain radiotherapy using four-field box technique with tilting baseplate for parotid gland sparing Jaehyeon Park, Ji Woon Yea Radiation Oncology Journal.2019; 37(1): 22. CrossRef