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Simultaneous Integrated Vs. Sequential Boost in Vmat Radiotherapy of High-Grade Gliomas; [Vergleich Zwischen Simultan Integriertem Boost Und Sequenziellem Boost Fur Die Vmat-Strahlentherapie Bei Hochgradigen Gliomen] Publisher Pubmed



Farzin M1, 2 ; Molls M1 ; Astner S1 ; Rondak IC3 ; Oechsner M1
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Authors Affiliations
  1. 1. Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universitat Munchen, Ismaninger Strasse 22, Munich, 81675, Germany
  2. 2. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Science, Tehran, Iran
  3. 3. Institut fur Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar, Technische Universitat Munchen, Munich, Germany

Source: Strahlentherapie und Onkologie Published:2015


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. © 2015, Springer-Verlag Berlin Heidelberg.