PMID- 19944589
OWN - NLM
STAT- MEDLINE
DCOM- 20110328
LR  - 20191210
IS  - 1873-4022 (Electronic)
IS  - 1873-4022 (Linking)
VI  - 35
IP  - 4
DP  - 2010 Winter
TI  - Helical tomotherapy-based STAT RT: Dosimetric evaluation for clinical 
      implementation of a rapid radiation palliation program.
PG  - 280-6
LID - 10.1016/j.meddos.2009.09.002 [doi]
AB  - Helical tomotherapy-based STAT radiation therapy (RT) uses an efficient software 
      algorithm for rapid intensity-modulated treatment planning, enabling conformal 
      radiation treatment plans to be generated on megavoltage computed tomography 
      (MVCT) scans for CT simulation, treatment planning, and treatment delivery in one 
      session. We compared helical tomotherapy-based STAT RT dosimetry with standard 
      linac-based 3D conformal plans and standard helical tomotherapy-based 
      intensity-modulated radiation therapy (IMRT) dosimetry for palliative treatments 
      of whole brain, a central obstructive lung mass, multilevel spine disease, and a 
      hip metastasis. Specifically, we compared the conformality, homogeneity, and dose 
      with regional organs at risk (OARs) for each plan as an initial step in the 
      clinical implementation of a STAT RT rapid radiation palliation program. 
      Hypothetical planning target volumes (PTVs) were contoured on an anthropomorphic 
      phantom in the lung, spine, brain, and hip. Treatment plans were created using 
      three planning techniques: 3D conformal on Pinnacle(3), helical tomotherapy, and 
      helical tomotherapy-based STAT RT. Plan homogeneity, conformality, and dose to 
      OARs were analyzed and compared. STAT RT and tomotherapy improved conformality 
      indices for spine and lung plans (CI spine = 1.21, 1.17; CI lung = 1.20, 1.07, 
      respectively) in comparison with standard palliative 
      anteroposterior/posteroanterior (AP/PA) treatment plans (CI spine = 7.01, CI lung 
      = 7.30), with better sparing of heart, esophagus, and spinal cord. For palliative 
      whole-brain radiotherapy, STAT RT and tomotherapy reduced maximum and mean doses 
      to the orbits and lens (maximum/mean lens dose: STAT RT = 2.94/2.65 Gy, 
      tomotherapy = 3.13/2.80 Gy, Lateral opposed fields = 7.02/3.65 Gy), with an 
      increased dose to the scalp (mean scalp dose: STAT RT = 16.19 Gy, tomotherapy = 
      15.61 Gy, lateral opposed fields = 14.01 Gy). For bony metastatic hip lesions, 
      conformality with both tomotherapy techniques (CI = 1.01 each) is superior to 
      AP/PA treatments (CI = 1.21), as expected. Helical tomotherapy-based STAT RT 
      treatment planning provides clinically acceptable dosimetry, with conformality 
      and homogeneity that is superior to standard linac-based 3D conformal planning 
      and is only slightly inferior to standard helical tomotherapy IMRT dosimetry. 
      STAT RT facilitates rapid treatment planning and delivery for palliative 
      radiation of patients with metastatic disease, with relative sparing of adjacent 
      OARs compared with standard 3D conformal plans.
CI  - Copyright (c) 2010 American Association of Medical Dosimetrists. Published by 
      Elsevier Inc. All rights reserved.
FAU - McIntosh, Alyson
AU  - McIntosh A
AD  - Department of Radiation Oncology, University of Virginia, Charlottesville, USA.
FAU - Dunlap, Neal
AU  - Dunlap N
FAU - Sheng, Ke
AU  - Sheng K
FAU - Geezey, Constance
AU  - Geezey C
FAU - Turner, Benton
AU  - Turner B
FAU - Blackhall, Leslie
AU  - Blackhall L
FAU - Weiss, Geoffrey
AU  - Weiss G
FAU - Lappinen, Eric
AU  - Lappinen E
FAU - Larner, James M
AU  - Larner JM
FAU - Read, Paul W
AU  - Read PW
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20091029
PL  - United States
TA  - Med Dosim
JT  - Medical dosimetry : official journal of the American Association of Medical 
      Dosimetrists
JID - 8908862
SB  - IM
MH  - Computer Simulation
MH  - Humans
MH  - *Models, Biological
MH  - Neoplasms/*radiotherapy
MH  - Palliative Care/*methods
MH  - Radiometry/*methods
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Conformal/*methods
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
EDAT- 2009/12/01 06:00
MHDA- 2011/03/29 06:00
CRDT- 2009/12/01 06:00
PHST- 2009/05/18 00:00 [received]
PHST- 2009/07/29 00:00 [revised]
PHST- 2009/09/23 00:00 [accepted]
PHST- 2009/12/01 06:00 [entrez]
PHST- 2009/12/01 06:00 [pubmed]
PHST- 2011/03/29 06:00 [medline]
AID - S0958-3947(09)00092-2 [pii]
AID - 10.1016/j.meddos.2009.09.002 [doi]
PST - ppublish
SO  - Med Dosim. 2010 Winter;35(4):280-6. doi: 10.1016/j.meddos.2009.09.002. Epub 2009 
      Oct 29.