PMID- 26460996
OWN - NLM
STAT- MEDLINE
DCOM- 20160202
LR  - 20220409
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 93
IP  - 3
DP  - 2015 Nov 1
TI  - Single-Isocenter Multiple-Target Stereotactic Radiosurgery: Risk of Compromised 
      Coverage.
PG  - 540-6
LID - S0360-3016(15)03012-6 [pii]
LID - 10.1016/j.ijrobp.2015.07.2262 [doi]
AB  - PURPOSE: To determine the dosimetric effects of rotational errors on target 
      coverage using volumetric modulated arc therapy (VMAT) for multitarget 
      stereotactic radiosurgery (SRS). METHODS AND MATERIALS: This retrospective study 
      included 50 SRS cases, each with 2 intracranial planning target volumes (PTVs). 
      Both PTVs were planned for simultaneous treatment to 21 Gy using a 
      single-isocenter, noncoplanar VMAT SRS technique. Rotational errors of 0.5 degrees , 
      1.0 degrees , and 2.0 degrees  were simulated about all axes. The dose to 95% of the PTV (D95) 
      and the volume covered by 95% of the prescribed dose (V95) were evaluated using 
      multivariate analysis to determine how PTV coverage was related to PTV volume, 
      PTV separation, and rotational error. RESULTS: At 0.5 degrees  rotational error, D95 
      values and V95 coverage rates were >/=95% in all cases. For rotational errors of 
      1.0 degrees , 7% of targets had D95 and V95 values <95%. Coverage worsened substantially 
      when the rotational error increased to 2.0 degrees : D95 and V95 values were >95% for 
      only 63% of the targets. Multivariate analysis showed that PTV volume and 
      distance to isocenter were strong predictors of target coverage. CONCLUSIONS: The 
      effects of rotational errors on target coverage were studied across a broad range 
      of SRS cases. In general, the risk of compromised coverage increased with 
      decreasing target volume, increasing rotational error and increasing distance 
      between targets. Multivariate regression models from this study may be used to 
      quantify the dosimetric effects of rotational errors on target coverage given 
      patient-specific input parameters of PTV volume and distance to isocenter.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Roper, Justin
AU  - Roper J
AD  - Department of Radiation Oncology, Winship Cancer Institute of Emory University, 
      Atlanta, Georgia; Department of Biostatistics and Bioinformatics, Winship Cancer 
      Institute of Emory University, Atlanta, Georgia. Electronic address: 
      justin.roper@emory.edu.
FAU - Chanyavanich, Vorakarn
AU  - Chanyavanich V
AD  - Department of Radiation Oncology, Winship Cancer Institute of Emory University, 
      Atlanta, Georgia; Department of Biostatistics and Bioinformatics, Winship Cancer 
      Institute of Emory University, Atlanta, Georgia.
FAU - Betzel, Gregory
AU  - Betzel G
AD  - Department of Radiation Oncology, Winship Cancer Institute of Emory University, 
      Atlanta, Georgia; Department of Biostatistics and Bioinformatics, Winship Cancer 
      Institute of Emory University, Atlanta, Georgia.
FAU - Switchenko, Jeffrey
AU  - Switchenko J
AD  - Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory 
      University, Atlanta, Georgia.
FAU - Dhabaan, Anees
AU  - Dhabaan A
AD  - Department of Radiation Oncology, Winship Cancer Institute of Emory University, 
      Atlanta, Georgia; Department of Biostatistics and Bioinformatics, Winship Cancer 
      Institute of Emory University, Atlanta, Georgia.
LA  - eng
GR  - P30 CA138292/CA/NCI NIH HHS/United States
GR  - P30CA138292/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20150720
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Brain Neoplasms/*surgery
MH  - Confidence Intervals
MH  - Humans
MH  - Multivariate Analysis
MH  - Radiosurgery/*methods
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - *Radiotherapy Setup Errors
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Rotation
MH  - Statistics, Nonparametric
MH  - Time Factors
PMC - PMC4610743
MID - NIHMS720193
COIS- Conflict of Interest: none
EDAT- 2015/10/16 06:00
MHDA- 2016/02/03 06:00
PMCR- 2016/11/01
CRDT- 2015/10/14 06:00
PHST- 2014/09/16 00:00 [received]
PHST- 2015/06/12 00:00 [revised]
PHST- 2015/07/09 00:00 [accepted]
PHST- 2015/10/14 06:00 [entrez]
PHST- 2015/10/16 06:00 [pubmed]
PHST- 2016/02/03 06:00 [medline]
PHST- 2016/11/01 00:00 [pmc-release]
AID - S0360-3016(15)03012-6 [pii]
AID - 10.1016/j.ijrobp.2015.07.2262 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2015 Nov 1;93(3):540-6. doi: 
      10.1016/j.ijrobp.2015.07.2262. Epub 2015 Jul 20.