Dosimetry analysis on IMRT, VMAT, and HT technique in hippocampal sparing whole-brain radiotherapy


Author(s): Soehartati Gondhowiardjo, Hadi Nurhadi, Mahesa Auzan, Arie Munandar, Wahyu Edi Wibowo, Irwan Ramli, Sri Mutya Sekar Utami

Background: External radiation is frequently used to reduce brain metastases symptoms. Whole-brain palliative radiation technique is the standard treatment for cancer patient with brain metastases. The technique, however, caused deterioration of cognitive function due to post-radiation hippocampal inflammation. Hippocampal Sparing Whole Brain Radiotherapy (HS-WBRT) was used to lessen the side effect, however, the standard delivery technique has not been established. This study aimed to compare the dosimetric parameter between IMRT, VMAT, and HT technique on HS-WBRT. Methods: This explorative experimental study used brain metastases patient CT-plan data. Conformity Index, Homogeneity Index, Treatment Time, D98%, D2%, D50%, and Hippocampal D100% and DMax were assessed. Results: It was found that Homogeneity Index, Treatment Time, D98%, D2%, D50%, and Hippocampal D100%, were statistically different among three techniques, with HT giving the best results. There were no significant differences between IMRT and VMAT in other parameters, making both techniques feasible for sparing hippocampus with acceptable parameters. Conclusion: Further research is needed with larger samples to assess the best method among HS-WRBT technique to increase treatment efficacy.

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Editors List

  • Osamu Tanaka

    Osamu Tanaka
    Assistant Professor,
    Department of Radiation Oncology
    Asahi University Hospital
    Gifu city, Gifu, Japan

  • Maher Abdel Fattah Al-Shayeb

    Department of Surgical Sciences, Ajman University, UAE

  • Andrzej Zdziennicki

    Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)

  • Krzysztof Urbanski

    Head of the Oncology Gynecology Clinic, Oncology Center - Instytut im. Maria Sklodowska Curie, Department in Krakow (Krakow, Poland)

  • Andrzej Szawlowski

    Klinika Nowotworow Gornego Odcinka Uklad Digestii, Oncology Center - Institute (Warsaw, Poland)