Technology in cancer research & treatment
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Technol. Cancer Res. Treat. · Dec 2016
Normal Brain Sparing With Increasing Number of Beams and Isocenters in Volumetric-Modulated Arc Beam Radiosurgery of Multiple Brain Metastases.
Recent studies have reported about the application of volumetric-modulated arc radiotherapy in the treatment of multiple brain metastases. One of the key concerns for these radiosurgical treatments lies in the integral dose within the normal brain tissue, as it has been shown to increase with increasing number of brain tumors treated. In this study, we investigate the potential to improve normal brain tissue sparing specific to volumetric-modulated arc radiotherapy by increasing the number of isocenters and arc beams. ⋯ The study results, particularly for the solitary (N = 1) metastases case, directly challenged the general notion of dose equivalence among current radiosurgical modalities. In conclusion, multiple isocenter and multiple arc beam delivery solutions are capable of decreasing normal brain irradiation exposure for volumetric-modulated arc radiotherapy. However, there is further technological development in need for volumetric-modulated arc radiotherapy before similar dosimetric treatment plans could be achievable when compared to Gamma Knife radiosurgery.