Consideration of Optimal Evaluation Metrics for Internal Gross Tumor Dose Relevant to Tumor Response in Multi-fraction Stereotactic Radiosurgery of Brain Metastasis.

Kazuhiro Ohtakara, Kojiro Suzuki

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Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

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9citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

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9 citing papers in PubMed.

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5 · Who and what money

Authors and funding

2 authors.

Kazuhiro OhtakaraDepartment of Radiation Oncology, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Yatomi, JPN.

Kojiro SuzukiDepartment of Radiology, Aichi Medical University, Nagakute, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction In stereotactic radiosurgery (SRS) for brain metastasis (BM), the target dose inhomogeneity remains highly variable among modalities, irradiation techniques, and facilities, which can affect tumor response during and after multi-fraction SRS. Volumetric-modulated arcs (VMAs) can provide a concentrically-layered steep dose increase inside a gross tumor volume (GTV) boundary compared to dynamic conformal arcs. This study was conducted to review the optimal evaluation method for the internal GTV doses relevant to maximal response and local control, specifically to examine the significance of the doses 2 mm and 4 mm inside the GTV boundary in VMA-based SRS. Materials and methods This was a planning study for the clinical scenario of a single BM and targeted 25 GTVs of >0.50 cc, including eight spherical models with diameters of 10-45 mm and 17 clinical BMs (GTV: 0.72-44.33 cc). SRS plans were generated for each GTV using VMA with a 5-mm leaf-width multileaf collimator and the optimization that prioritized the steepness of the dose gradient outside the GTV boundary without any internal dose constraints. The dose prescription and evaluation were based on the GTV

Indexed as

biologically effective dosebrain metastasisdose evaluationdose gradientdose inhomogeneitygross tumor volumelocal controlmaximal tumor responsestereotactic radiosurgeryvolumetric-modulated arc therapy

Identifiers

PMID39184769

DOI10.7759/cureus.65338

PMCPMC11344629

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