SU‐FF‐T‐673: Application of RapidArc Technique to Cervical Spine Stereotactic Treatment
Purpose: Cervical spine (C‐spine) lesions are located more centrally than the rest of the spinal column making the c‐spine an ideal target for the RapidArc therapy technique. In this study, we explore the use of RapidArc to treat c‐spine patients and investigate the target coverage, cone‐beam CT (CBCT) localization, MU reduction, and intra‐fraction motion. Materials and Methods: We studied 3 RapidArc plans for c‐spine patients. The patients are immobilized with Brainlab head and neck frame. Single‐arc RapidArc plans are used for treatment. Before the treatment, CBCT images are acquired for target localization. After RapidArc is delivered, post‐treatment CBCT images are acquired to assess intra‐fraction motion. Actual dose to the spinal cord in CBCT was calculated with Eclipse planning system. Results: RapidArc plans can provide comparable target coverage and critical organ dose sparing as IMRT. The average CBCT set‐up correction was 0.4 ± 0.5 cm axial, 0.4 ± 0.6 cm sagittal, 0.0 ± 0.1 cm coronal, and a couch rotational correction of 1.6 ± 1.6 degrees. The typical MU reduction compared to IMRT was 56%. The intra‐fraction motion was −0.1 ± 0.2 cm axial, 0.1 ± 0.1 cm sagittal, −0.1 ± 0.2 cm coronal, and 0.7 ± 0.4 degrees. Typical treatment delivery time (not including set‐up) was reduced by approximately 80%. The actual average cord dose received in the patient was 1 ± 0.25 % greater than the planned dose to the cord. The actual dose at the highest 0.5% of the short cord next to the target was 7 ± 4% greater than the planned dose. Conclusion: RapidArc is well suited for c‐spine treatments and provides an effective way to substantially decrease patient treatment time which aids in decreasing intra‐fraction motion as well as improving the comfort level for the patient. © 2009, American Association of Physicists in Medicine. All rights reserved.
Brooks, A; Yin, F; Kirkpatrick, J; Wang, Z
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