The impact of unscheduled gaps and iso-centre sequencing on the biologically effective dose in Gamma Knife radiosurgery.

IF 0.7 Q4 SURGERY Journal of radiosurgery and SBRT Pub Date : 2021-01-01

Thomas Klinge, Marc Modat, Jamie R McClelland, Alexis Dimitriadis, Ian Paddick, John W Hopewell, Lee Walton, Jeremy Rowe, Neil Kitchen, Sébastien Ourselin

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Abstract

Purpose: Establish the impact of iso-centre sequencing and unscheduled gaps in Gamma Knife® (GK) radiosurgery on the biologically effective dose (BED).

Methods: A BED model was used to study BED values on the prescription iso-surface of patients treated with GK Perfexion™ (Vestibular Schwannoma). The effect of a 15 min gap, simulated at varying points in the treatment delivery, and adjustments to the sequencing of iso-centre delivery, based on average dose-rate, was quantified in terms of the impact on BED.

Results: Depending on the position of the gap and the average dose-rate profiles, the mean BED values were decreased by 0.1% to 9.9% of the value in the original plan. A heuristic approach to iso-centre sequencing showed variations in BED of up to 14.2%, relative to the mean BED of the original sequence.

Conclusion: The treatment variables, like the iso-centre sequence and unscheduled gaps, should be considered during GK radiosurgery treatments.

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非计划间隙和等中心测序对伽玛刀放射外科生物有效剂量的影响。

目的:建立伽玛刀(GK)放射手术中等中心测序和非计划间隙对生物有效剂量(BED)的影响。方法:采用BED模型研究GK Perfexion™(前庭神经鞘瘤)治疗患者处方等面BED值。在治疗递送的不同点模拟15分钟间隙的影响，并根据平均剂量率调整等中心递送的顺序，根据对BED的影响进行量化。结果:根据间隙位置和平均剂量率分布，平均BED值比原计划降低0.1% ~ 9.9%。一种启发式的等中心测序方法显示，相对于原始序列的平均BED, BED的变异高达14.2%。结论:GK放射外科治疗应考虑等中心序列和非预定间隙等治疗变量。

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来源期刊

Journal of radiosurgery and SBRT SURGERY-

CiteScore

1.40

自引率

8.30%

发文量