Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2010 Jul 2;11(4):3245.
doi: 10.1120/jacmp.v11i4.3245.

Helical TomoTherapy versus sterotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison

Tushar Kumar  1 , Joseph Rakowski, Bo Zhao, Mazin Alkhafaji, Jacob Burmeister, Tammy Austin, Maria Vlachaki
Affiliations
Comparative Study

Helical TomoTherapy versus sterotactic Gamma Knife radiosurgery in the treatment of single and multiple brain tumors: a dosimetric comparison

Tushar Kumar et al. J Appl Clin Med Phys. .

Abstract

The objective was to compare the dosimetry of Helical TomoTherapy (TOMO) and Gamma Knife (GK) treatment plans for tumor and normal brain in the treatment of single and multiple brain tumors. An anthropomorphic Rando Head phantom was used to compare the dosimetry of TOMO and GK. Eight brain tumors of various shapes, sizes and locations were used to generate 10 plans. The radiation dose was 20 Gy prescribed to the 100% isodose line for TOMO plans and to the 50% for the GK plans. Dose Volume Histograms for tumor and brain were compared. Equivalent Uniform Dose (gEUD), Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) were performed and used for plan comparisons. Average minimum, mean, median and maximum tumor doses were 19.93, 27.83, 27.38, 39.60 Gy for GK and 20.17, 20.60, 20.59, 20.90 Gy for TOMO. Average gEUD values for tumor and normal brain were 25.0 and 7.2 Gy for GK and 20.7 and 8.1 Gy for TOMO. Conformity indices (CI) were similar for both modalities. Gradient indices (GI) were greater for TOMO. A combination plan was also generated using all eight tumors. TOMO was able to target all eight tumors simultaneously resulting in mean tumor and brain doses of 20.5 and 9.35 Gy, respectively. Due to the maximum limit of 50 beams per plan, GK was unable to provide a treatment plan for all eight tumors. GK provides an advantage for all tumor sizes with respect to tumor and normal brain dose. Clinical studies are needed to correlate these dosimetric findings with patient outcomes.

PubMed Disclaimer

Figures

Figure 1(a)
Figure 1(a)
DVH of 7mm lesion.
Figure 1(b)
Figure 1(b)
DVH of 10 mm lesion.
Figure 1(c)
Figure 1(c)
DVH of 30 mm lesion.
Figure 1(d)
Figure 1(d)
DVH of 20 mm lesion.
Figure 1(e)
Figure 1(e)
DVH of three lesions (20 mm, 20 mm central, 30 mm).
Figure 1(f)
Figure 1(f)
DVH of 40 mm central lesion.
Figure 1(g)
Figure 1(g)
DVH of 40 mm peripheral lesion.
Figure 1(h)
Figure 1(h)
DVH of irregular peripheral lesion.
Figure 1(i)
Figure 1(i)
DVH of irregular central lesion.
Figure 2(a)
Figure 2(a)
Isodose distribution and gamma histogram of 7 mm lesion in TomoTherapy.
Figure 2(b)
Figure 2(b)
Isodose distribution and gamma histogram of central irregular lesion in TomoTherapy.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aragon‐Ching JB, Zujewski JA. CNS metastasis: an old problem in a new guise. Clin Cancer Res. 2007;13(6):1644–47. - PubMed
    1. Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomized trial. Lancet. 2004;363(9422):1665–72. - PubMed
    1. Aoyama H, Shirato H, Tago M, et al. Stereotactic radiosurgery plus whole‐brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA. 2006;295(21):2483–91. - PubMed
    1. Bhatnagar AK, Flickinger JC, Kondziolka D, Lunsford LD. Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys. 2006;64(3):898–903. - PubMed
    1. Rades D, Kueter JD, Pluemer A, Veninga T, Schild SE. Matched‐pair analysis comparing whole‐brain radiotherapy plus stereotactic radiosurgery versus surgery plus whole‐brain radiotherapy and a boost to the metastatic site for one or two brain metastases. Int J Radiat Oncol Biol Phys. 2009;73(4):1077–81. - PubMed

Publication types