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Investigating the Number of Radiation Fields in Intensity-Modulated Radiotherapy Plans of Optic Nerve Sheath Meningioma Patients Using Dose Gradient Index Publisher Pubmed



Mazloomi F1 ; Abedi I2 ; Shanei A2 ; Dalvand F3 ; Amouheidari A4
Authors
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Authors Affiliations
  1. 1. Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Faculty Member of Medical Physics Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Shahid Beheshti University, Tehran, Iran
  4. 4. Radiation Oncologist, Radiation Oncology Department, Isfahan Milad Hospital, Isfahan, Iran

Source: Biomedical Physics and Engineering Express Published:2022


Abstract

Purpose: In optic nerve radiotherapy, vital organs are very close to the target volume, they are highly sensitive to radiation and have low dose tolerance. In this regard, evaluating dose fall-off steepness around the target volume is required to assess various intensity-modulated radiation therapy (IMRT) plans in the treatment of the optic nerve sheath meningioma (ONSM) patients. Materials and Methods: Thirteen ONSM patients were analyzed with three IMRT techniques, including three (IMRT-3F), five (IMRT-5F), and seven fields (IMRT-7F). These plans were studied using Dmean, Dmax, D2%, D98%, V100%, uniformity index (UI), homogeneity index (HI), conformity index (CI), and specifically the dose gradient indices (DGIs). Results: The values of Dmax and Dmean for IMRT-3F, IMRT-5F and IMRT-7F were (5637.42 ± 57.08, 5322.84 ± 83.86), (5670.51 ± 67.87, 5383.00 ± 58.45), and (5692.99 ± 31.65, 5405.72 ± 51.73), respectively, which were increased with increment in the number of IMRT fields from 3 to 7. The UI and HI indices were significantly different between IMRT-3F and IMRT-7F (p = 0.010 and p = 0.005, respectively), and CI was close to the ideal value (0.99 ± 0.01) in IMRT-7F. The significant findings of the dose gradient indices represented smaller values in IMRT-7F, which led to a faster dose fall-off, particularly at the 70%-85% isodose levels around the target. Conclusion: Increasing the number of radiation fields in IMRT treatment plans of ONSM patients had a considerable difference in both the dosimetric parameters of the target volume and at-risk organs, as well as the dose gradient indices. Overall, IMRT-7F could be considered as a preferred technique in the treatment of this meningioma. © 2022 IOP Publishing Ltd.
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