Dosimetric comparison of TomoTherapy and non-coplanar VMAT for hippocampal-avoidance prophylactic cranial irradiation.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
추출되지 않음
I · Intervention 중재 / 시술
HA-PCI were retrospectively analyzed
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSIONS] Non-coplanar VMAT demonstrated superior dosimetric characteristics compared to TomoTherapy for HA-PCI with 3-mm margin, meeting hippocampal constraints while improving target coverage and treatment efficiency. Prospective validation with neurocognitive outcomes is needed.
[PURPOSE] To compare the dosimetric characteristics of non-coplanar volumetric modulated arc therapy (VMAT) and TomoTherapy for hippocampal-avoidance prophylactic cranial irradiation (HA-PCI) in small
- p-value p=0.004
APA
Lee YK, Cheon W, et al. (2026). Dosimetric comparison of TomoTherapy and non-coplanar VMAT for hippocampal-avoidance prophylactic cranial irradiation.. Frontiers in oncology, 16, 1790929. https://doi.org/10.3389/fonc.2026.1790929
MLA
Lee YK, et al.. "Dosimetric comparison of TomoTherapy and non-coplanar VMAT for hippocampal-avoidance prophylactic cranial irradiation.." Frontiers in oncology, vol. 16, 2026, pp. 1790929.
PMID
41948500
Abstract
[PURPOSE] To compare the dosimetric characteristics of non-coplanar volumetric modulated arc therapy (VMAT) and TomoTherapy for hippocampal-avoidance prophylactic cranial irradiation (HA-PCI) in small cell lung cancer (SCLC) patients.
[METHODS] Ten SCLC patients who received HA-PCI were retrospectively analyzed. Two plans were generated as TrueBeam non-coplanar VMAT with four arcs and helical TomoTherapy. The hippocampal avoidance zone used a 3-mm margin, reduced from RTOG 0933's 5-mm specification. Planning target volume of whole brain (PTV_WB) was prescribed 25 Gy in 10 fractions, normalized to D=2500 cGy. RTOG 0933 hippocampal constraints (D ≤ 1600 cGy, D≤900 cGy) were applied. Dosimetric parameters for hippocampus, PTV_WB, organs at risk, treatment efficiency (monitor units, delivery time), Paddick conformity index, and homogeneity index were compared using Wilcoxon signed-rank test.
[RESULTS] Non-coplanar VMAT achieved significantly lower hippocampal D than TomoTherapy (1353 cGy 1638 cGy, p=0.004), meeting RTOG 0933 constraints, while TomoTherapy exceeded the per-protocol constraint by 38 cGy but remained within the acceptable deviation threshold, indicating clinically acceptable dosimetric outcomes. Non-coplanar VMAT demonstrated superior PTV_WB coverage: V (96.68% 95.77%), V (97.66% 96.48%), D (2320 cGy 2095 cGy) (all p=0.004). Paddick conformity index was higher (0.91 0.84, p=0.012) and homogeneity index lower (0.20 0.27, p=0.004). Non-coplanar VMAT reduced monitor units by 88.5% (748 6528 MU, p=0.004) and treatment time by 25.2% (287 384 seconds, p=0.004). Bilateral eye D was 21-27% lower (all p=0.004) and bilateral cochlear D approximately 15% lower (p ≤ 0.008).
[CONCLUSIONS] Non-coplanar VMAT demonstrated superior dosimetric characteristics compared to TomoTherapy for HA-PCI with 3-mm margin, meeting hippocampal constraints while improving target coverage and treatment efficiency. Prospective validation with neurocognitive outcomes is needed.
[METHODS] Ten SCLC patients who received HA-PCI were retrospectively analyzed. Two plans were generated as TrueBeam non-coplanar VMAT with four arcs and helical TomoTherapy. The hippocampal avoidance zone used a 3-mm margin, reduced from RTOG 0933's 5-mm specification. Planning target volume of whole brain (PTV_WB) was prescribed 25 Gy in 10 fractions, normalized to D=2500 cGy. RTOG 0933 hippocampal constraints (D ≤ 1600 cGy, D≤900 cGy) were applied. Dosimetric parameters for hippocampus, PTV_WB, organs at risk, treatment efficiency (monitor units, delivery time), Paddick conformity index, and homogeneity index were compared using Wilcoxon signed-rank test.
[RESULTS] Non-coplanar VMAT achieved significantly lower hippocampal D than TomoTherapy (1353 cGy 1638 cGy, p=0.004), meeting RTOG 0933 constraints, while TomoTherapy exceeded the per-protocol constraint by 38 cGy but remained within the acceptable deviation threshold, indicating clinically acceptable dosimetric outcomes. Non-coplanar VMAT demonstrated superior PTV_WB coverage: V (96.68% 95.77%), V (97.66% 96.48%), D (2320 cGy 2095 cGy) (all p=0.004). Paddick conformity index was higher (0.91 0.84, p=0.012) and homogeneity index lower (0.20 0.27, p=0.004). Non-coplanar VMAT reduced monitor units by 88.5% (748 6528 MU, p=0.004) and treatment time by 25.2% (287 384 seconds, p=0.004). Bilateral eye D was 21-27% lower (all p=0.004) and bilateral cochlear D approximately 15% lower (p ≤ 0.008).
[CONCLUSIONS] Non-coplanar VMAT demonstrated superior dosimetric characteristics compared to TomoTherapy for HA-PCI with 3-mm margin, meeting hippocampal constraints while improving target coverage and treatment efficiency. Prospective validation with neurocognitive outcomes is needed.
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