Dose fall-off during the treatment of thoracic spine metastasis with CyberKnife stereotactic body radiation therapy (SBRT)

  • Zhongjian Ju Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Sanya, China Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
  • Jingyuan Wang Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
  • Huaiwen Zhang Department of Radiotherapy, Jiang-Xi Cancer Hospital, Nanchang, China
  • Lei Du Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Sanya, China
  • Wei Xu Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
  • Xiaoshen Wang Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
  • Ruigang Ge Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
  • Jiwei Li Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
  • Qingzeng Zheng Department of Radiotherapy, Beijing Geriatric Hospital, Beijing, China
  • Jianxiong Li Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Sanya, China
Keywords: CyberKnife, dosage, radiation, stereotactic body radiation therapy, SBRT thoracic spine metastasis, dose gradient

Abstract

CyberKnife stereotactic body radiation therapy (SBRT) is becoming increasingly used for cancer treatment and, to maximize its clinical application, it is important to define the dosimetric characteristics, optimal dose and fractionation regimens. The aim of this study was to evaluate the dose fall-off in two fractionated regimens of CyberKnife SBRT during the treatment of thoracic spinal metastasis. Patients with spinal metastasis involving a vertebra and pedicle were treated with 40 Gy in 5 fractions (n = 4), and patients with spinal metastasis involving only a vertebra received 33 Gy in 3 fractions (n = 4). A new approach was used to measure absolute dose fall-off distance, relative dose fall-off distance, and the dose fall-off per unit distance along four reference directions in the axial plane. Patients treated with 33 Gy/3 fractions had a greater absolute dose fall-off distance in direction 1 (from the point with maximum dose [Dmax] towards the spinal cord) and direction 3 (the opposite of the direction 1), a greater relative dose fall-off distance in direction 3, and a lower dose fall-off per unit distance in direction 1 and 3 compared to patients treated with 40 Gy/5 fractions (all p < 0.05). Overall, the dose fall-off towards the spinal cord is rapid during the treatment of thoracic spinal metastasis with CyberKnife SBRT, which allows a higher dose of radiation to be delivered to the tumor and, at the same time, better protection of the spinal cord.

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Author Biographies

Zhongjian Ju, Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Sanya, China Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China

Department of Radiation Oncology

Department of Radiotherapy

 

Jingyuan Wang, Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
Department of Radiotherapy
Huaiwen Zhang, Department of Radiotherapy, Jiang-Xi Cancer Hospital, Nanchang, China
Department of Radiotherapy
Lei Du, Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Sanya, China
Department of Radiation Oncology
Wei Xu, Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
Department of Radiotherapy
Xiaoshen Wang, Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
Department of Radiotherapy
Ruigang Ge, Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
Department of Radiotherapy
Jiwei Li, Department of Radiotherapy, Chinese PLA General Hospital, Beijing, China
Department of Radiotherapy
Qingzeng Zheng, Department of Radiotherapy, Beijing Geriatric Hospital, Beijing, China
Department of Radiotherapy
Jianxiong Li, Department of Radiation Oncology, Hainan Branch of Chinese PLA General Hospital, Sanya, China
Department of Radiation Oncology

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Published
2018-08-02
How to Cite
1.
Ju Z, Wang J, Zhang H, Du L, Xu W, Wang X, Ge R, Li J, Zheng Q, Li J. Dose fall-off during the treatment of thoracic spine metastasis with CyberKnife stereotactic body radiation therapy (SBRT). BJBMS [Internet]. 2Aug.2018 [cited 21Feb.2019];. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/3185
Section
New and Emerging Methods