Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations

<p>Abstract</p> <p>Purpose</p> <p>To report the initial institute experience in terms of dosimetric and technical aspects in stereotactic body radiation therapy (SBRT) delivered using flattening filter free (FFF) beam in patients with liver lesions.</p> <p>M...

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Main Authors: Mancosu Pietro, Castiglioni Simona, Reggiori Giacomo, Catalano Maddalena, Alongi Filippo, Pellegrini Chiara, Arcangeli Stefano, Tozzi Angelo, Lobefalo Francesca, Fogliata Antonella, Navarria Piera, Cozzi Luca, Scorsetti Marta
Format: Article
Language:English
Published: BMC 2012-02-01
Series:Radiation Oncology
Subjects:
Online Access:http://www.ro-journal.com/content/7/1/16
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author Mancosu Pietro
Castiglioni Simona
Reggiori Giacomo
Catalano Maddalena
Alongi Filippo
Pellegrini Chiara
Arcangeli Stefano
Tozzi Angelo
Lobefalo Francesca
Fogliata Antonella
Navarria Piera
Cozzi Luca
Scorsetti Marta
author_facet Mancosu Pietro
Castiglioni Simona
Reggiori Giacomo
Catalano Maddalena
Alongi Filippo
Pellegrini Chiara
Arcangeli Stefano
Tozzi Angelo
Lobefalo Francesca
Fogliata Antonella
Navarria Piera
Cozzi Luca
Scorsetti Marta
author_sort Mancosu Pietro
collection DOAJ
description <p>Abstract</p> <p>Purpose</p> <p>To report the initial institute experience in terms of dosimetric and technical aspects in stereotactic body radiation therapy (SBRT) delivered using flattening filter free (FFF) beam in patients with liver lesions.</p> <p>Methods and Materials</p> <p>From October 2010 to September 2011, 55 consecutive patients with 73 primary or metastatic hepatic lesions were treated with SBRT on TrueBeam using FFF beam and RapidArc technique. Clinical target volume (CTV) was defined on multi-phase CT scans, PET/CT, MRI, and 4D-CT. Dose prescription was 75 Gy in 3 fractions to planning target volume (PTV). Constraints for organs at risk were: 700 cc of liver free from the 15 Gy isodose, D<sub>max </sub>< 21 Gy for stomach and duodenum, D<sub>max </sub>< 30 Gy for heart, D<sub>0.1 cc </sub>< 18 Gy for spinal cord, V<sub>15 Gy </sub>< 35% for kidneys. The dose was downscaled in cases of not full achievement of dose constraints. Daily cone beam CT (CBCT) was performed.</p> <p>Results</p> <p>Forty-three patients with a single lesion, nine with two lesions and three with three lesions were treated with this protocol. Target and organs at risk objectives were met for all patients. Mean delivery time was 2.8 ± 1.0 min. Pre-treatment plan verification resulted in a Gamma Agreement Index of 98.6 ± 0.8%. Mean on-line co-registration shift of the daily CBCT to the simulation CT were: -0.08, 0.05 and -0.02 cm with standard deviations of 0.33, 0.39 and 0.55 cm in, vertical, longitudinal and lateral directions respectively.</p> <p>Conclusions</p> <p>SBRT for liver targets delivered by means of FFF resulted to be feasible with short beam on time.</p>
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spelling doaj.art-691262e1950e4b45bb98f1152203cbae2022-12-21T18:00:34ZengBMCRadiation Oncology1748-717X2012-02-01711610.1186/1748-717X-7-16Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerationsMancosu PietroCastiglioni SimonaReggiori GiacomoCatalano MaddalenaAlongi FilippoPellegrini ChiaraArcangeli StefanoTozzi AngeloLobefalo FrancescaFogliata AntonellaNavarria PieraCozzi LucaScorsetti Marta<p>Abstract</p> <p>Purpose</p> <p>To report the initial institute experience in terms of dosimetric and technical aspects in stereotactic body radiation therapy (SBRT) delivered using flattening filter free (FFF) beam in patients with liver lesions.</p> <p>Methods and Materials</p> <p>From October 2010 to September 2011, 55 consecutive patients with 73 primary or metastatic hepatic lesions were treated with SBRT on TrueBeam using FFF beam and RapidArc technique. Clinical target volume (CTV) was defined on multi-phase CT scans, PET/CT, MRI, and 4D-CT. Dose prescription was 75 Gy in 3 fractions to planning target volume (PTV). Constraints for organs at risk were: 700 cc of liver free from the 15 Gy isodose, D<sub>max </sub>< 21 Gy for stomach and duodenum, D<sub>max </sub>< 30 Gy for heart, D<sub>0.1 cc </sub>< 18 Gy for spinal cord, V<sub>15 Gy </sub>< 35% for kidneys. The dose was downscaled in cases of not full achievement of dose constraints. Daily cone beam CT (CBCT) was performed.</p> <p>Results</p> <p>Forty-three patients with a single lesion, nine with two lesions and three with three lesions were treated with this protocol. Target and organs at risk objectives were met for all patients. Mean delivery time was 2.8 ± 1.0 min. Pre-treatment plan verification resulted in a Gamma Agreement Index of 98.6 ± 0.8%. Mean on-line co-registration shift of the daily CBCT to the simulation CT were: -0.08, 0.05 and -0.02 cm with standard deviations of 0.33, 0.39 and 0.55 cm in, vertical, longitudinal and lateral directions respectively.</p> <p>Conclusions</p> <p>SBRT for liver targets delivered by means of FFF resulted to be feasible with short beam on time.</p>http://www.ro-journal.com/content/7/1/16SBRTliverflattening filter freeRapidArcTrueBeam
spellingShingle Mancosu Pietro
Castiglioni Simona
Reggiori Giacomo
Catalano Maddalena
Alongi Filippo
Pellegrini Chiara
Arcangeli Stefano
Tozzi Angelo
Lobefalo Francesca
Fogliata Antonella
Navarria Piera
Cozzi Luca
Scorsetti Marta
Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations
Radiation Oncology
SBRT
liver
flattening filter free
RapidArc
TrueBeam
title Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations
title_full Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations
title_fullStr Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations
title_full_unstemmed Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations
title_short Stereotactic body radiation therapy for liver tumours using flattening filter free beam: dosimetric and technical considerations
title_sort stereotactic body radiation therapy for liver tumours using flattening filter free beam dosimetric and technical considerations
topic SBRT
liver
flattening filter free
RapidArc
TrueBeam
url http://www.ro-journal.com/content/7/1/16
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