Current practices of craniospinal irradiation techniques in Turkey: a comprehensive dosimetric analysis
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info:eu-repo/semantics/openAccessAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/.Tarih
2024Yazar
Şenkesen, ÖznurTezcanlı, Evrim
Alkaya, Fadime
İspir, Burçin
Çatlı, Serap
Yeşil, Abdullah
Bezirganoğlu, Ebrar
Turan, Sezgi
Köksal, Canan
Güray, Gülay
Hacıislamoğlu, Emel
Durmuş, İsmail Faruk
Çavdar, Şeyma
Aksu, Telat
Çolak, Nurten
Küçükmorkoç, Esra
Doğan, Mustafa
Ercan, Tülay
Karaköse, Fatih
Alpan, Vildan
Ceylan, Cemile
Poyraz, Gökhan
Nalbant, Nilgül
Kınay, Şeyda
İpek, Servet
Kayalılar, Namık
Tatlı, Hamza
Zhu, Mingyao
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Şenkesen, Ö., Tezcanlı, E., Alkaya, F., İspir, B., Çatlı, S., Yeşil, A. ... Zhu, M. (2024). Current practices of craniospinal irradiation techniques in Turkey: a comprehensive dosimetric analysis. Radiation Oncology, 19(1). http://dx.doi.org/10.1186/s13014-024-02435-4Özet
Objective: This study evaluates various craniospinal irradiation (CSI) techniques used in Turkish centers to understand their advantages, disadvantages and overall effectiveness, with a focus on enhancing dose distribution. Methods: Anonymized CT scans of adult and pediatric patients, alongside target volumes and organ-at-risk (OAR) structures, were shared with 25 local radiotherapy centers. They were tasked to develop optimal treatment plans delivering 36 Gy in 20 fractions with 95% PTV coverage, while minimizing OAR exposure. The same CT data was sent to a US proton therapy center for comparison. Various planning systems and treatment techniques (3D conformal RT, IMRT, VMAT, tomotherapy) were utilized. Elekta Proknow software was used to analyze parameters, assess dose distributions, mean doses, conformity index (CI), and homogeneity index (HI) for both target volumes and OARs. Comparisons were made against proton therapy. Results: All techniques consistently achieved excellent PTV coverage (V95 > 98%) for both adult and pediatric patients. Tomotherapy closely approached ideal Dmean doses for all PTVs, while 3D-CRT had higher Dmean for PTV_brain. Tomotherapy excelled in CI and HI for PTVs. IMRT resulted in lower pediatric heart, kidney, parotid, and eye doses, while 3D-CRT achieved the lowest adult lung doses. Tomotherapy approached proton therapy doses for adult kidneys and thyroid, while IMRT excelled for adult heart, kidney, parotid, esophagus, and eyes. Conclusion: Modern radiotherapy techniques offer improved target coverage and OAR protection. However, 3D techniques are continued to be used for CSI. Notably, proton therapy stands out as the most efficient approach, closely followed by Tomotherapy in terms of achieving superior target coverage and OAR protection.
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Radiation OncologyCilt
19Sayı
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