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논문 기본 정보

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학술저널
저자정보
Yoon, Kyoung Jun (Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine) Cho, Byungchul (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) Kwak, Jung Won (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) Lee, Doheui (Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine) Kwon, Do Hoon (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) Ahn, Seung Do (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) Lee, Sang-Wook (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) Kim, Chang Jin (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) Roh, Sung Woo (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) Cho, Young Hyun (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제61권 제6호
발행연도
2018.1
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753 - 760 (8page)

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Objective : We investigated the effect of optimization in dose-limiting shell method on the dosimetric quality of CyberKnife (CK) plans in treating brain metastases (BMs). Methods : We selected 19 BMs previously treated using CK between 2014 and 2015. The original CK plans ($CK_{original}$) had been produced using 1 to 3 dose-limiting shells : one at the prescription isodose level (PIDL) for dose conformity and the others at low-isodose levels (10-30% of prescription dose) for dose spillage. In each case, a modified CK plan ($CK_{modified}$) was generated using 5 dose-limiting shells : one at the PIDL, another at intermediate isodose level (50% of prescription dose) for steeper dose fall-off, and the others at low-isodose levels, with an optimized shell-dilation size based on our experience. A Gamma Knife (GK) plan was also produced using the original contour set. Thus, three data sets of dosimetric parameters were generated and compared. Results : There were no differences in the conformity indices among the $CK_{original}$, $CK_{modified}$, and GK plans (mean 1.22, 1.18, and 1.24, respectively; p=0.079) and tumor coverage (mean 99.5%, 99.5%, and 99.4%, respectively; p=0.177), whereas the $CK_{modified}$ plans produced significantly smaller normal tissue volumes receiving 50% of prescription dose than those produced by the $CK_{original}$ plans (p<0.001), with no statistical differences in those volumes compared with GK plans (p=0.345). Conclusion : These results indicate that significantly steeper dose fall-off is able to be achieved in the CK system by optimizing the shell function while maintaining high conformity of dose to tumor.
#Radiosurgery #Brain #Neoplasm metastasis

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참고문헌 (25)

참고문헌 신청
Blonigen BJ / 2010 / Irradiated volume as a predictor of brain radionecrosis after linear accelerator stereotactic radiosurgery / Int J Radiat Oncol Biol Phys 77:996~1001 google schola Chin LS / 2001 / Radiation necrosis following gamma knife surgery:a case-controlled comparison of treatment parameters and longterm clinical follow up / J Neurosurg 94:899~904 google schola Cho YH / 2015 / Experiences on two different stereotactic radiosurgery modalities of Gamma Knife and Cyberknife in treating brain metastases / Acta neurochir (Wien) 157:2003~2009 google schola Fahrig A / 2007 / Hypofractionated stereotactic radiotherapy for brain metastases--results from three different dose concepts / Strahlenther Onkol 183:625~630 google schola Feuvret L / 2014 / Stereotactic radiotherapy for large solitary brain metastases / Cancer Radiother 18:97~106 google schola

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