Erschienen in:
01.12.2015 | Original Article
Simultaneous integrated vs. sequential boost in VMAT radiotherapy of high-grade gliomas
verfasst von:
Dr. med. Mostafa Farzin, MD, Prof. Dr. med. Michael Molls, PD Dr. med. Sabrina Astner, Ina-Christine Rondak, Dipl.-Stat., Dr. rer. nat. Markus Oechsner, PhD
Erschienen in:
Strahlentherapie und Onkologie
|
Ausgabe 12/2015
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Abstract
Background
In 20 patients with high-grade gliomas, we compared two methods of planning for volumetric-modulated arc therapy (VMAT): simultaneous integrated boost (SIB) vs. sequential boost (SEB). The investigation focused on the analysis of dose distributions in the target volumes and the organs at risk (OARs).
Method
After contouring the target volumes [planning target volumes (PTVs) and boost volumes (BVs)] and OARs, SIB planning and SEB planning were performed. The SEB method consisted of two plans: in the first plan the PTV received 50 Gy in 25 fractions with a 2-Gy dose per fraction. In the second plan the BV received 10 Gy in 5 fractions with a dose per fraction of 2 Gy. The doses of both plans were summed up to show the total doses delivered. In the SIB method the PTV received 54 Gy in 30 fractions with a dose per fraction of 1.8 Gy, while the BV received 60 Gy in the same fraction number but with a dose per fraction of 2 Gy.
Results
All of the OARs showed higher doses (Dmax and Dmean) in the SEB method when compared with the SIB technique. The differences between the two methods were statistically significant in almost all of the OARs. Analysing the total doses of the target volumes we found dose distributions with similar homogeneities and comparable total doses.
Conclusion
Our analysis shows that the SIB method offers advantages over the SEB method in terms of sparing OARs.