Preserving memory function in whole-brain radiation Therapy: Efficacy of HyperArc and Coplanar VMAT techniques
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S. Muthu , G. Mudhana  |
Department of Physics, School of Advanced Sciences, Vellore Institute of Technology, Chennai, India |
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Abstract: (136 Views) |
Background: This study assessed the efficacy of HyperArc planning for whole-brain radiation therapy (WBRT) with hippocampal sparing, comparing it to conventional coplanar volumetric modulated arc therapy (VMAT) techniques using high-definition multileaf-collimators (HDMLC) and millennium MLC (MMLC). Materials and Methods: In this retrospective study, 25 patients with brain metastases received hippocampus-sparing WBRT by RTOG-0933 trial guidelines. Three treatment plans (HyperArc, VMAT-HDMLC, VMAT-MMLC) were created using Eclipse v16.1 Treatment Planning System (TPS), with a prescribed dose of 30Gy in 10 fractions. The Dosimetric parameters assessed included D98%, D2%, HI, Dmax for PTVeval, and Dmax, Dmean, and D100% for hippocampus and other critical structures. Additionally, Monitor Units (MUs) and delivery checks using portal dosimetry were considered. Results: All plans met RTOG-0933 criteria for PTV and OARs. HyperArc matched VMAT-HDMLC in D98% (28.41 Gy vs. 28.38 Gy), outperforming VMAT-MMLC (28.04 Gy). HyperArc surpassed both VMAT techniques in D2% (32.83 Gy vs. 33.24 Gy vs. 34.06 Gy), HI (0.14 vs. 0.15 vs. 0.18), and Dmax (34.84 Gy vs. 35.5 Gy vs. 36.36 Gy). In hippocampus sparing, HyperArc achieved lower Dmax (12.99 Gy vs. 13.73 Gy vs. 14.76 Gy), Dmean (9.58 Gy vs. 10.23 Gy vs. 10.64 Gy), and D100% (8.25 Gy vs. 8.70 Gy vs. 8.85 Gy) values. Further, the HyperArc method provided better organ-at-risk sparing and higher gamma results. Conclusion: All three methods met RTOG-0933 dosimetric goals, with HyperArc outperforming VMAT. Optimized VMAT collimator angles at 0° and 90° improved organ-at-risk doses, exceeding conventional planning in PTV coverage and hippocampal sparing. |
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Keywords: Whole brain radiotherapy, hippocampus avoidance, HyperArc, VMAT, MLC. |
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Full-Text [PDF 1367 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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