Yeungnam Univ J Med.  2019 Jan;36(1):36-42. 10.12701/yujm.2019.00087.

Non-coplanar whole brain radiotherapy is an effective modality for parotid sparing

• Park J
• Park JW
• Yea JW

• KMID: 2434097
• DOI: http://doi.org/10.12701/yujm.2019.00087

Abstract

BACKGROUND
The purpose of this study was to evaluate the efficacy and feasibility of non-coplanar whole brain radiotherapy (NC-WBRT) for parotid sparing.
METHODS
Fifteen cases, previously treated with WBRT were selected. NC-WBRT plans were generated. The beam arrangement for the non-coplanar plans consisted of superior anterior, right, and left beams. After generation of the non-coplanar plans a field-in-field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC-WBRT plans were subsequently compared with the previously generated bilateral WBRT (B-WBRT) plans. A field-in-field technique was also used with the B-WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.
RESULTS
The mean dose to the parotid gland for the two different plans were 16.2 Gy with B-WBRT and 13.7 Gy with NC-WBRT (p < 0.05). In the NC-WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p < 0.05) than those of the B-WBRT plan. The Dmax of the lens was also lower by 10% with NC-WBRT.
CONCLUSION
The use of NC-WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose-volume parameters of the parotid gland.

Keyword

Organ at risk; Parotid gland; Whole brain radiotherapy; Xerostomia

MeSH Terms

Brain*
Institutional Practice
Methods
Parotid Gland
Radiotherapy*
Xerostomia

Figure

• 

  Fig. 1. Beam’s eye view. (A) Superior anterior field of the NC–WBRT. (B) Field–in–field of B–WBRT. NC-WBRT, non–coplanar whole brain radiotherapy; B–WBRT, bilateral whole brain radiotherapy.

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  Fig. 2. Dose–volume histogram of parotid gland for B–WBRT and NC–WBRT. B–WBRT, bilateral whole brain radiotherapy; NC-WBRT, non–coplanar whole brain radiotherapy. PTV, planning target volume; CTV, clinical target volume; lt., left; rt., right.

• 

  Fig. 3. Boxplot of Dmean and V5–V25 for (A) right, (B) left, and (C) both parotid gland. B–WBRT, bilateral whole brain radiotherapy; NC-WBRT, non–coplanar whole brain radiotherapy.

Reference

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