Lumbar Vertebral Marrow Metastasis: A Comparison of Three-Field and Four-Field Three-Dimensional Conformal Radiotherapy (3DCRT)

Abstract

Author(s): Wisam Nghaimesh Tuaib, Ruwaidah Abd Aalameer Mussttaf

Background: Metastasis to the bone marrow in the vertebrae is a symptom of cancer that may be treated palliative. The purpose of this research was to evaluate the relative merits of the three-field and fourfield approaches to 3D conformal radiation. Materials and Methods: Forty patients with malignancies that had spread to their lumbar vertebral marrow received CT simulation as part of their radiation treatment plan. The obtained CT images were then used with the Monaco v5.3 Treatment Planning System (TPS) for delineation and treatment planning. The Elekta-made agility linear accelerator was used to administer the radiation. To facilitate this evaluation, two separate plan types were developed: the three-field approach and the four-field approach. Results: The statistical analysis of lumber vertebral marrow metastasis tumors using the PTV 95%, PTV 105%, and PTV 2% parameters shows that the four-field technique is superior to the three-field technique. The four-field technique provides a greater mean dose to the tumor volume for PTV 95%, PTV 105%, and PTV 2%. These results suggest that the fourfield technique may be a more effective treatment option for patients with vertebral marrow metastasis tumors. The research used the homogeneity index (HI), the conformity index, and the efficiency index to evaluate strategies for three and four fields. According to the findings, the Homogeneity Index (HI) and the Conformity Index (CI) were both considerably higher for the four-field method than for the three-field method (CI). The strategies of both methods were consistent with one another. The kidneys are more protected by the three-field approach, whereas the spinal cord is better shielded by the four-field method. Conclusion: The four-field approach is more successful than the threefield strategy in reducing radiation dosage to the spinal cord. In contrast, the three-field strategy is more successful than the four-field technique for protecting the kidneys. The four-field planning approach achieves a more uniform dose distribution within the target volume for lumbar spinal bone metastases

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