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:: Volume 23, Issue 2 (5-2025) ::
Int J Radiat Res 2025, 23(2): 335-339 Back to browse issues page
Preserving memory function in whole-brain radiation Therapy: Efficacy of HyperArc and Coplanar VMAT techniques
S. Muthu , G. Mudhana
Department of Physics, School of Advanced Sciences, Vellore Institute of Technology, Chennai, India
Abstract:   (339 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.
Keywords: Whole brain radiotherapy, hippocampus avoidance, HyperArc, VMAT, MLC.
Full-Text [PDF 1367 kb]   (92 Downloads)    
Type of Study: Original Research | Subject: Radiation Biology
References
1. 1.Gondi V, Tomé WA, Mehta MP (2010) Why avoid the hippocam-pus? A comprehensive review. Radiother Oncol, 97: 370-6. [DOI:10.1016/j.radonc.2010.09.013]
2. Raber J (2010) Unintended effects of cranial irradiation on cogni-tive function. Toxicol Pathol, 38: 198-202. [DOI:10.1177/0192623309352003]
3. Abayomi OK (1996) Pathogenesis of irradiation-induced cognitivedysfunction. Acta Oncol, 35: 659-63. [DOI:10.3109/02841869609083995]
4. Gondi V, Pugh SL, Tome WA, et al. (2014) Preservation of memory with conformal avoidance of the hippocampal neural stem-cellcompartment during whole-brain radiotherapy for brain metasta- [DOI:10.1200/JCO.2014.57.2909]
5. ses (RTOG 0933): a phase II multi-institutional trial. J Clin Oncol, 32: 3810-6.
6. Prado A, Milanés AI, et al. (2019) Dosimetric comparison of fourvolumetric-modulated Arc therapy beam arrangements utilized forhippocampal-sparing whole-brain radiation therapy. J Med Phys,44: 1-8. [DOI:10.4103/jmp.JMP_56_18]
7. Shen J, Bender E, et al. (2015). An efficient Volumetric Arc Therapytreatment planning approach for hippocampal-avoidance whole-brain radiation therapy (HA-WBRT). Med Dosim, 40: 205-9. [DOI:10.1016/j.meddos.2014.11.007]
8. Yuen AHL, Wu PM, et al. (2020) Volumetric modulated arc therapy(VMAT) for hippocampal-avoidance whole brain radiation therapy:planning comparison with Dual-arc and Split-arc partial-field tech-niques. Radiat Oncol, 15: 42. [DOI:10.1186/s13014-020-01488-5]
9. Vergalasova I, Liu H, et al. (2019) Multi-Institutional Dosimetricevaluation of modern day stereotactic radiosurgery (SRS) treat-ment options for multiple brain metastases. Front Oncol, 9: 483. [DOI:10.3389/fonc.2019.00483]
10. Smyth G, Evans PM, Bamber JC, Bedford JL (2019) Recent develop-ments in non-coplanar radiotherapy. Br J Radiol, 92: 20180908. [DOI:10.1259/bjr.20180908]
11. Ruggieri R, Naccarato S, et al. (2018) Linac-based VMAT radiosur-gery for multiple brain lesions: comparison between a convention-al multi-isocenter approach and a new dedicated mono-isocentertechnique. Radiat Oncol, 13: 38. [DOI:10.1186/s13014-018-0985-2]
12. Ohira S, Ueda Y, et al. (2018) HyperArc VMAT planning for single and multiple brain metastases stereotactic radiosurgery: a new treatment planning approach. Radiat Oncol, 13: 13. [DOI:10.1186/s13014-017-0948-z]
13. Lyu Q, O'Connor D, et al. (2018) VMAT optimization with dynamiccollimator rotation. Med Phys, 45: 2399-2410. [DOI:10.1002/mp.12915]
14. Kim JI, Ahn BS, et al. (2018) Optimal collimator rotation based onthe outline of multiple brain targets in VMAT. Radiat Oncol, 13: 88. [DOI:10.1186/s13014-018-1039-5]
15. Kamst O and Desai P (2023) Evaluation of HyperArc™ using filmand portal dosimetry quality assurance. Phys Eng Sci Med, 46: 57-66. [DOI:10.1007/s13246-022-01197-1]
16. Miften M, Olch A, et al. (2018) Tolerance limits and methodologiesfor IMRT measurement-based verification QA: Recommendations of AAPM Task Group No. 218. Med Phys, 45: e53-e83. [DOI:10.1002/mp.12810]
17. Muthu S and Mudhana G (2024) Dosimetric systems in pre-treatment QA for stereotactic treatments: correlation agreementsand target volume dependency. Asian Pac J Cancer Prev, 25: 1425-1432. [DOI:10.31557/APJCP.2024.25.4.1425]
18. Siglin J,Champ CE, Vakhnenko Y, et al. (2014) Optimizing patient positioning for intensity modulated radiation therapy in hippocam-pal-sparing whole brain radiation therapy. Pract Radiat Oncol, 4: 378-83. [DOI:10.1016/j.prro.2013.11.008]
19. Sprowls CJ, Shah AP, et al. (2021) Whole brain radiotherapy withhippocampal sparing using Varian HyperArc. Med Dosim, 46: 264-268. [DOI:10.1016/j.meddos.2021.02.007]
20. Monk JE, et al. (2003) Comparison of a micro-multileaf collimatorwith a 5-mm-leaf-width collimator for intracranial stereotacticradiotherapy. Int J Radiat Oncol Biol Phys, 57: 1443-9. [DOI:10.1016/S0360-3016(03)01579-7]
21. Hong CS, et al. (2014) Dosimetric effects of multileaf collimatorleaf width on intensity-modulated radiotherapy for head and neckcancer. Med Phys, 41: 021712. [DOI:10.1118/1.4860155]
22. Venencia CD, et al. (2023) Rotational effect and dosimetric impact:HDMLC vs 5-mm MLC leaf width in single isocenter multiple me-tastases radiosurgery with Brainlab ElementsTM. Journal of Radio-therapy in Practice, 22: e35. [DOI:10.1017/S1460396922000048]
23. Sood S, Pokhrel D, McClinton C, et al. (2017) Volumetric modulat-ed arc therapy (VMAT) for whole brain radiotherapy: not only forhippocampal sparing, but also for reduction of dose to organs atrisk. Med Dosim, 42: 375-383. [DOI:10.1016/j.meddos.2017.07.005]
24. Rong Y, Evans J, et al. (2015) Dosimetric evaluation of intensity-modulated radiotherapy, volumetric modulated arc therapy, andhelical tomotherapy for hippocampal-avoidance whole brain radio-therapy. PLoS One, 10: e0126222. [DOI:10.1371/journal.pone.0126222]
25. Yuen AHL, et al. (2020) Volumetric modulated arc therapy (VMAT) for hippocampal-avoidance whole brain radiation therapy: plan-ning comparison with Dual-arc and Split-arc partial-field tech-niques. Radiat Oncol, 15: 42. [DOI:10.1186/s13014-020-01488-5]
26. Varian Medical System. Eclipse photon and electron algorithms reference guide. Varian Medical Systems, Inc. 2015. 3100 Hansen, Way Palo Alto, CA 94304-1038 United States of America.
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Muthu S, Mudhana G. Preserving memory function in whole-brain radiation Therapy: Efficacy of HyperArc and Coplanar VMAT techniques. Int J Radiat Res 2025; 23 (2) :335-339
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Volume 23, Issue 2 (5-2025) Back to browse issues page
International Journal of Radiation Research
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