Research Article
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Comparison of Single and Multiple Treatment Plans Made in CyberKnife® Radiosurgery System on Phantom

Year 2023, Volume: 44 Issue: 2, 384 - 388, 30.06.2023
https://doi.org/10.17776/csj.1260686

Abstract

While the use of CyberKnife® radiosurgery systems is increasing, the choice of treatment plan is also important. In this study, it was aimed to determine the more advantageous application by comparing the irradiation of all metastases at once and the protocols of irradiation of metastases separately in multiple brain metastases. For this, on an entirely new head phantom; 6 brain metastases and 3 critical organs, including the spinal cord, brain stem, and chiasm, were determined over the spaces where the dosimeters were placed. Computed tomography (CT) images of the head phantom were taken and these 6 tumors and 3 critical organs were drawn (contouring) on the image. In the treatment planning system, the dose we wanted to give was written and irradiation plans were created to be done separately with a single irradiation. Luminescence (OSL) dosimeters with BeO optical excitation were removed from the phantom after each irradiation and the count value obtained from the dosimeter reader device was recorded. Homogeneity index (HI), conformity index (CI), new conformity index (nCI), duration of treatment, and gradient index (GI) values of irradiation at one time and separately were compared. While it was found that irradiation of tumors with a separate treatment plan was more advantageous in terms of conformity index (CI), new conformity index (nCI), homogeneity index (HI), and coverage values, it was seen that a single plan was more suitable in terms of gradient index and duration.

Supporting Institution

Selçuk University Scientific Research Project Grant

Project Number

BAP (21111004)

Thanks

The authors thank Medical Physics Specialist Mehmet Fazıl ENKAVI and Eng. İsmail Burak KORKUT from PHYSMART Medikal for their contributions.This research was supported by the Selçuk University. Research Grant, BAP (21111004).This work is part of K. Sözen's doctoral thesis.

References

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  • [2] Stanley J., Breitman K., Dunscombe P., Spencer D.P., Lau H., Evaluation of stereotactic radiosurgery conformity indices for 170 target volumes in patients with brain metastases. J Appl Clin Med Phys., (2011) 3449.
  • [3] O'Beirn M., Benghiat H., Meade S., Heyes G., Sawlani V., Kong A., Hartley A., Sanghera P., The Expanding Role of Radiosurgery for Brain Metastases. Medicines., 5(3) (2018) 90.
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  • [6] Acker G., Hashemi S. M., Fuellhase J., Kluge A., Conti A., Kufeld M., Kreimeier A., Loebel F., Kord M., Sladek D., Stromberger C., Budach V., Vajkoczy P., Senger C., Efficacy and safety of CyberKnife radiosurgery in elderly patients with brain metastases: a retrospective clinical evaluation. Radiation Oncology, 225(15) (2020) 1-10.
  • [7] Cao T., Dai Z., Ding Z.,- Li w., Quan H., Analysis of different evaluation indexes for prostate stereotactic body radiation therapy plans: conformity index, homogeneity index and gradient index. Precision Radiation Oncology, 3(3) (2019) 72-79.
  • [8] Kataria T., Sharma K., Subramani V., Karrthick K. P., Bisht S. S., Homogeneity Index: An objective tool for assessment of conformal radiation treatments. J Med Phys., 37(4) (2012) 207-13.
  • [9] Paddick I., Lippitz B., A simple dose gradient measurement tool to complement the conformity index. J. Neurosurg., 105 (2006) 194-201.
  • [10] Zhang S., Yang R. Shi C., Li J., Zhuang H., Tian S., Wang J., Noncoplanar VMAT for Brain Metastases: A Plan Quality and Delivery Efficiency Comparison with Coplanar VMAT, IMRT, and CyberKnife. Technol Cancer Res Treat., 18 (2019) 1-8.
  • [11] Narayanasamy G., Stathakis S., Gutierrez A.N., Pappas E., Crownover R., Floyd JR 2nd., Papanikolaou N., A Systematic Analysis of 2 Monoisocentric Techniques for the Treatment of Multiple Brain Metastases. Technol Cancer Res Treat.,16(5) (2017) 639-644.
  • [12] Sio T.T., Jang S., Lee S.-W., Curran B., Pyakuryal A.P., Sternick, E.S., Comparing gamma knife and cyberknife in patients with brain metastases. J Appl Clin Med Phys., 15(1) (2014) 14-26.
  • [13] Yan L., Xu Y., Chen X., Xie X., Liang B., Dai J., A new homogeneity index definition for evaluation of radiotherapy plans. J Appl Clin Med Phys., 20(11) (2019) 50-56.
  • [14] Fares J., Cordero A., Kanojia D., Lesniak M.S., The Network of Cytokines in Brain Metastases. Cancers., 13(1) (2021).
  • [15] Miller K.D., Nogueira L., Mariotto A.B., Rowland J.H., Yabroff K.R., Alfano C.M., Jemal A., Kramer J.L., Siegel R.L., Cancer treatment and survivorship statistics. CA Cancer J Clin., 69(5) (2019) 363-385.
  • [16] Yoon M., Park S.Y., Shin D., Lee S.B., Pyo H.R., Kim D.Y., Cho, K.H., A new homogeneity index based on statistical analysis of the dose-volume histogram. J Appl Clin Med Phys., 8(2) (2007) 9-17.
  • [17] Feuvret L., Noel G., Mazeron J. J., Bey P., Conformity index: a review. Int J Radiat Oncol Biol Phys., 64(2) (2006) 333-421.
  • [18] Lomax N.J., Scheib S.G., Quantifying the degree of conformity in radiosurgery treatment planning. Int J Radiat Oncol Biol Phys., 55(5) (2003) 1409-19.
  • [19] Yu X., Wang Y., Yuan Z., Yu H., Song Y., Zhao L., Wang P., Benefit of dosimetry distribution for patients with multiple brain metastases from non-small cell lung cancer by a Cyberknife stereotactic radiosurgery (SRS) system. BMC Cancer., 20(1) (2020) 1144.
  • [20] Uzel E., CyberKnife Radyocerrahi sisteminde çoklu beyin metastazlarının tedavi planlamasının dozimetrik olarak iyileştirilmesi ve incelenmesi, Master thesis, Ankara Yıldırım Beyazıt University, Health Sciences Institute, (2019).
Year 2023, Volume: 44 Issue: 2, 384 - 388, 30.06.2023
https://doi.org/10.17776/csj.1260686

Abstract

Project Number

BAP (21111004)

References

  • [1] Kotecha R., Gondi V., Ahluwalia M.S., Brastianos P.K., Mehta M.P., Recent advances in managing brain metastasis. F1000Res., 7 (2018) 1772.
  • [2] Stanley J., Breitman K., Dunscombe P., Spencer D.P., Lau H., Evaluation of stereotactic radiosurgery conformity indices for 170 target volumes in patients with brain metastases. J Appl Clin Med Phys., (2011) 3449.
  • [3] O'Beirn M., Benghiat H., Meade S., Heyes G., Sawlani V., Kong A., Hartley A., Sanghera P., The Expanding Role of Radiosurgery for Brain Metastases. Medicines., 5(3) (2018) 90.
  • [4] McGuinness M.C., Gottschalk A.R., Lessard E., Nakamura J.L., Pinnaduwage D., Pouliot J., Sims C., Descovich M., Investigating the clinical advantages of a robotic linac equipped with a multileaf collimator in the treatment of brain and prostate cancer patients. Clin Med Phy., (2015) 16.
  • [5] Antypas C., Pantelis, Performance evaluation of a CyberKnife G4 image-guided robotic stereotactic radiosurgery system. Phys Med Biol., 53(17) (2008) 4697-718.
  • [6] Acker G., Hashemi S. M., Fuellhase J., Kluge A., Conti A., Kufeld M., Kreimeier A., Loebel F., Kord M., Sladek D., Stromberger C., Budach V., Vajkoczy P., Senger C., Efficacy and safety of CyberKnife radiosurgery in elderly patients with brain metastases: a retrospective clinical evaluation. Radiation Oncology, 225(15) (2020) 1-10.
  • [7] Cao T., Dai Z., Ding Z.,- Li w., Quan H., Analysis of different evaluation indexes for prostate stereotactic body radiation therapy plans: conformity index, homogeneity index and gradient index. Precision Radiation Oncology, 3(3) (2019) 72-79.
  • [8] Kataria T., Sharma K., Subramani V., Karrthick K. P., Bisht S. S., Homogeneity Index: An objective tool for assessment of conformal radiation treatments. J Med Phys., 37(4) (2012) 207-13.
  • [9] Paddick I., Lippitz B., A simple dose gradient measurement tool to complement the conformity index. J. Neurosurg., 105 (2006) 194-201.
  • [10] Zhang S., Yang R. Shi C., Li J., Zhuang H., Tian S., Wang J., Noncoplanar VMAT for Brain Metastases: A Plan Quality and Delivery Efficiency Comparison with Coplanar VMAT, IMRT, and CyberKnife. Technol Cancer Res Treat., 18 (2019) 1-8.
  • [11] Narayanasamy G., Stathakis S., Gutierrez A.N., Pappas E., Crownover R., Floyd JR 2nd., Papanikolaou N., A Systematic Analysis of 2 Monoisocentric Techniques for the Treatment of Multiple Brain Metastases. Technol Cancer Res Treat.,16(5) (2017) 639-644.
  • [12] Sio T.T., Jang S., Lee S.-W., Curran B., Pyakuryal A.P., Sternick, E.S., Comparing gamma knife and cyberknife in patients with brain metastases. J Appl Clin Med Phys., 15(1) (2014) 14-26.
  • [13] Yan L., Xu Y., Chen X., Xie X., Liang B., Dai J., A new homogeneity index definition for evaluation of radiotherapy plans. J Appl Clin Med Phys., 20(11) (2019) 50-56.
  • [14] Fares J., Cordero A., Kanojia D., Lesniak M.S., The Network of Cytokines in Brain Metastases. Cancers., 13(1) (2021).
  • [15] Miller K.D., Nogueira L., Mariotto A.B., Rowland J.H., Yabroff K.R., Alfano C.M., Jemal A., Kramer J.L., Siegel R.L., Cancer treatment and survivorship statistics. CA Cancer J Clin., 69(5) (2019) 363-385.
  • [16] Yoon M., Park S.Y., Shin D., Lee S.B., Pyo H.R., Kim D.Y., Cho, K.H., A new homogeneity index based on statistical analysis of the dose-volume histogram. J Appl Clin Med Phys., 8(2) (2007) 9-17.
  • [17] Feuvret L., Noel G., Mazeron J. J., Bey P., Conformity index: a review. Int J Radiat Oncol Biol Phys., 64(2) (2006) 333-421.
  • [18] Lomax N.J., Scheib S.G., Quantifying the degree of conformity in radiosurgery treatment planning. Int J Radiat Oncol Biol Phys., 55(5) (2003) 1409-19.
  • [19] Yu X., Wang Y., Yuan Z., Yu H., Song Y., Zhao L., Wang P., Benefit of dosimetry distribution for patients with multiple brain metastases from non-small cell lung cancer by a Cyberknife stereotactic radiosurgery (SRS) system. BMC Cancer., 20(1) (2020) 1144.
  • [20] Uzel E., CyberKnife Radyocerrahi sisteminde çoklu beyin metastazlarının tedavi planlamasının dozimetrik olarak iyileştirilmesi ve incelenmesi, Master thesis, Ankara Yıldırım Beyazıt University, Health Sciences Institute, (2019).
There are 20 citations in total.

Details

Primary Language English
Subjects Classical Physics (Other)
Journal Section Natural Sciences
Authors

Kevser Sözen 0009-0005-9561-4674

Hasan Uysal 0000-0002-4867-304X

Nihal Büyükçizmeci 0000-0002-6030-9574

Kaan Oysul 0000-0002-4359-318X

Project Number BAP (21111004)
Publication Date June 30, 2023
Submission Date March 20, 2023
Acceptance Date June 8, 2023
Published in Issue Year 2023Volume: 44 Issue: 2

Cite

APA Sözen, K., Uysal, H., Büyükçizmeci, N., Oysul, K. (2023). Comparison of Single and Multiple Treatment Plans Made in CyberKnife® Radiosurgery System on Phantom. Cumhuriyet Science Journal, 44(2), 384-388. https://doi.org/10.17776/csj.1260686