1
|
Berthet C, Lucia F, Bourbonne V, Schick U, Lecouillard I, Le Deroff C, Barateau A, de Crevoisier R, Castelli J. The dosimetric parameters impact on local recurrence in stereotactic radiotherapy for brain metastases. Br J Radiol 2024; 97:820-827. [PMID: 38377402 PMCID: PMC11025672 DOI: 10.1093/bjr/tqae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/15/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES Stereotactic radiotherapy (SRT) for brain metastases (BM) allows very good local control (LC). However, approximately 20%-30% of these lesions will recur. The objective of this retrospective study was to evaluate the impact of dosimetric parameters on LC in cerebral SRT. METHODS Patients treated with SRT for 1-3 BM between January 2015 and December 2018 were retrospectively included. A total of 349 patients with 538 lesions were included. The median gross tumour volume (GTV) was 2 cm3 (IQR, 0-7). The median biological effective dose with α/β = 10 (BED10) was 60 Gy (IQR, 32-82). The median prescription isodose was 71% (IQR, 70-80). Correlations with LC were examined using the Cox regression model. RESULTS The median follow-up period was 55 months (min-max, 7-85). Median overall survival was 17.8 months (IQR, 15.2-21.9). There were 95 recurrences and LC at 1 and 2 years was 87.1% (95% CI, 84-90) and 78.1% (95% CI, 73.9-82.4), respectively. Univariate analysis showed that systemic treatment, dose to 2% and 50% of the planning target volume (PTV), BED10 > 50 Gy, and low PTV and GTV volume were significantly correlated with better LC. In the multivariate analysis, GTV volume, isodose, and BED10 were significantly associated with LC. CONCLUSION These results show the importance of a BED10 > 50 Gy associated with a prescription isodose <80% to optimize LC during SRT for BM. ADVANCES IN KNOWLEDGE Isodose, BED, and GTV volume were significantly associated with LC. A low isodose improves LC without increasing the risk of radionecrosis.
Collapse
Affiliation(s)
- Camille Berthet
- Radiation Oncology Department, CLCC Eugene Marquis, Rennes, 35000, France
| | - François Lucia
- Radiation Oncology Department, University Hospital, Brest, 29200, France
| | - Vincent Bourbonne
- Radiation Oncology Department, University Hospital, Brest, 29200, France
| | - Ulrike Schick
- Radiation Oncology Department, University Hospital, Brest, 29200, France
| | | | - Coralie Le Deroff
- Radiation Oncology Department, CLCC Eugene Marquis, Rennes, 35000, France
| | - Anais Barateau
- Radiation Oncology Department, CLCC Eugene Marquis, Rennes, 35000, France
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI – UMR 1099, Rennes, 35000, France
| | - Renaud de Crevoisier
- Radiation Oncology Department, CLCC Eugene Marquis, Rennes, 35000, France
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI – UMR 1099, Rennes, 35000, France
| | - Joel Castelli
- Radiation Oncology Department, CLCC Eugene Marquis, Rennes, 35000, France
- Univ Rennes, CLCC Eugène Marquis, Inserm, LTSI – UMR 1099, Rennes, 35000, France
| |
Collapse
|
2
|
Conlon D, Connolly J, Galal M, Ahmed I, Foley M, Kleefeld C. Analysis of CyberKnife intracranial treatment plans using ICRU 91 dose reporting: A retrospective study. J Appl Clin Med Phys 2023:e13932. [PMID: 36794436 DOI: 10.1002/acm2.13932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 01/08/2023] [Accepted: 01/24/2023] [Indexed: 02/17/2023] Open
Abstract
ICRU 91, published in 2017, is an international standard for prescribing, recording, and reporting stereotactic treatments. Since its release, there has been limited research published on the implementation and impact of ICRU 91 on clinical practice. This work provides an assessment of the recommended ICRU 91 dose reporting metrics for their use in clinical treatment planning. A set of 180 intracranial stereotactic treatment plans for patients treated by the CyberKnife (CK) system were analyzed retrospectively using the ICRU 91 reporting metrics. The 180 plans comprised 60 trigeminal neuralgia (TGN), 60 meningioma (MEN), and 60 acoustic neuroma (AN) cases. The reporting metrics included the planning target volume (PTV) near-minimum dose ( D near - min ${D}_{{\rm{near}} - {\rm{min}}}$ ), near-maximum dose ( D near - max ${D}_{{\rm{near}} - {\rm{max}}}$ ), and median dose ( D 50 % ${D}_{50{\rm{\% }}}$ ), as well as the gradient index (GI) and conformity index (CI). The metrics were assessed for statistical correlation with several treatment plan parameters. In the TGN plan group, owing to the small targets, D near - min ${D}_{{\rm{near}} - {\rm{min}}}$ was greater than D near - max ${D}_{{\rm{near}} - {\rm{max}}}$ in 42 plans, whereas both metrics were not applicable in 17 plans. The D 50 % ${D}_{50{\rm{\% }}}$ metric was predominantly influenced by the prescription isodose line (PIDL). The GI was significantly dependent on target volume in all analyses performed, where the variables were inversely related. The CI was only dependent on target volume in treatment plans for small targets. The ICRU 91 D near - min ${D}_{{\rm{near}} - {\rm{min}}}$ and D near - max ${D}_{{\rm{near}} - {\rm{max}}}$ metrics breakdown in plans for small target volumes below 1 cm3 ; the Min and Max pixel should be reported in such cases. The D 50 % ${D}_{50{\rm{\% }}}$ metric is of limited use for treatment planning. Given their volume dependence, the GI and CI metrics could potentially serve as plan evaluation tools in the planning of the sites analyzed in this study, which would ultimately improve treatment plan quality.
Collapse
Affiliation(s)
- Dion Conlon
- School of Physics, University of Galway, Galway, Ireland.,Department of Medical Physics, Blackrock Health Galway Clinic, Galway, Ireland
| | - James Connolly
- Department of Medical Physics, Blackrock Health Hermitage Medical Clinic, Dublin, Ireland
| | - Mohamed Galal
- Department of Medical Physics, Blackrock Health Hermitage Medical Clinic, Dublin, Ireland
| | - Ismail Ahmed
- Department of Medical Physics, Blackrock Health Hermitage Medical Clinic, Dublin, Ireland
| | - Mark Foley
- School of Physics, University of Galway, Galway, Ireland
| | | |
Collapse
|
3
|
Takizawa T, Tanabe S, Nakano H, Utsunomiya S, Sakai M, Maruyama K, Takeuchi S, Nakano T, Ohta A, Kaidu M, Ishikawa H, Onda K. The impact of target positioning error and tumor size on radiobiological parameters in robotic stereotactic radiosurgery for metastatic brain tumors. Radiol Phys Technol 2022; 15:135-146. [DOI: 10.1007/s12194-022-00655-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 12/01/2022]
|
4
|
Hellerbach A, Eichner M, Rueß D, Luyken K, Hoevels M, Judge M, Baues C, Ruge M, Kocher M, Treuer H. Impact of prescription isodose level and collimator selection on dose homogeneity and plan quality in robotic radiosurgery. Strahlenther Onkol 2021; 198:484-496. [PMID: 34888732 PMCID: PMC9038902 DOI: 10.1007/s00066-021-01872-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
Purpose In stereotactic radiosurgery (SRS), prescription isodoses and resulting dose homogeneities vary widely across different platforms and clinical entities. Our goal was to investigate the physical limitations of generating dose distributions with an intended level of homogeneity in robotic SRS. Methods Treatment plans for non-isocentric irradiation of 4 spherical phantom targets (volume 0.27–7.70 ml) and 4 clinical targets (volume 0.50–5.70 ml) were calculated using Sequential (phantom) or VOLOTM (clinical) optimizers (Accuray, Sunnyvale, CA, USA). Dose conformity, volume of 12 Gy isodose (V12Gy) as a measure for dose gradient, and treatment time were recorded for different prescribed isodose levels (PILs) and collimator settings. In addition, isocentric irradiation of phantom targets was examined, with dose homogeneity modified by using different collimator sizes. Results Dose conformity was generally high (nCI ≤ 1.25) and varied little with PIL. For all targets and collimator sets, V12Gy was highest for PIL ≥ 80% and lowest for PIL ≤ 65%. The impact of PIL on V12Gy was highest for isocentric irradiation and lowest for clinical targets (VOLOTM optimization). The variability of V12Gy as a function of collimator selection was significantly higher than that of PIL. V12Gy and treatment time were negatively correlated. Plans utilizing a single collimator with a diameter in the range of 70–80% of the target diameter were fastest, but showed the strongest dependence on PIL. Conclusion Inhomogeneous dose distributions with PIL ≤ 70% can be used to minimize dose to normal tissue. PIL ≥ 90% is associated with a marked and significant increase in off-target dose exposure. Careful selection of collimators during planning is even more important. Supplementary Information The online version of this article (10.1007/s00066-021-01872-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alexandra Hellerbach
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Markus Eichner
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Daniel Rueß
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Klaus Luyken
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Mauritius Hoevels
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Michael Judge
- Faculty of Medicine and University Hospital Cologne, Institute of Radiation Oncology, University of Cologne, Cologne, Germany
| | - Christian Baues
- Faculty of Medicine and University Hospital Cologne, Institute of Radiation Oncology, University of Cologne, Cologne, Germany
| | - Maximilian Ruge
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Martin Kocher
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Harald Treuer
- Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| |
Collapse
|
5
|
Xu Q, Kubicek G, Mulvihill D, Goldman W, Eastwick G, Turtz A, Fan J, Luo D. Evaluating the impact of prescription isodose line on plan quality using Gamma Knife inverse planning. J Appl Clin Med Phys 2021; 22:289-297. [PMID: 34402582 PMCID: PMC8425871 DOI: 10.1002/acm2.13388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/09/2022] Open
Abstract
The impact of selection of prescription isodose line (IDL) on plan quality has not been well evaluated during inverse planning (IP). In this study, a total of 180 IP plans at five levels of IDL were generated for 30 brain metastases (BMs). For each BM, one round of IP was performed with typical IP settings, followed by a quick fine‐tuning to ensure the same target coverage and comparable conformality index. The impact of the IDL on the quality metrics (selectivity, gradient index [GI], and treatment time) was evaluated. The decrease of selectivity and increase of GI meant inferior target dose conformality and more dose spillage. Additionally, a metric directly correlated to the treatment time was proposed. For all cases, the mean GI decreased monotonically as IDL decreased from 70% to 30%, and the decreasing rate was significantly different based on tumor size. The mean selectivity and number of shots decreased monotonically as IDL decreased for all the tumors. From 70% to 30% IDL, the decreasing rate of the mean selectivity was 2.8% (p = 0.020), 7.7% (p = 0.005), and 15.4% (p = 0.020) and that of the number of shots was 75.4% (p = 0.001), 73.2% (p = 0.001), and 50.7% (p = 0.009), for the large, medium, and small tumors, respectively. For the medium and small tumor groups, the mean treatment time increased monotonically when IDLs decreased (increasing rate was 80.0% [p = 0.002] for medium tumors [p = 0.001] and 130.8% [p = 0.001] for small tumors from 70% to 30%). For the large tumors, the mean treatment time was the shortest at 50% IDL (59.0 min) and higher at 70% (65.9 min) and 30% (71.9 min). Overall, the GammaPlan chose smaller sectors for plans with lower IDLs except for the large size group.
Collapse
Affiliation(s)
- Qianyi Xu
- Department of Radiation Oncology, MD Anderson Cancer Center at Cooper, Camden, NJ, USA.,Department of Radiation Oncology, Inova Health System, Fairfax, VA, USA
| | - Gregory Kubicek
- Department of Radiation Oncology, MD Anderson Cancer Center at Cooper, Camden, NJ, USA
| | - David Mulvihill
- Department of Radiation Oncology, MD Anderson Cancer Center at Cooper, Camden, NJ, USA
| | - Warren Goldman
- Department of Neurosurgery, Cooper Medical School, Rowan University, Camden, NJ, USA
| | - Gary Eastwick
- Department of Radiation Oncology, MD Anderson Cancer Center at Cooper, Camden, NJ, USA
| | - Alan Turtz
- Department of Neurosurgery, Cooper Medical School, Rowan University, Camden, NJ, USA
| | - Jiajin Fan
- Department of Radiation Oncology, Inova Health System, Fairfax, VA, USA
| | - Dershan Luo
- Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
6
|
Margin-Free Fractionated Stereotactic Radiation Therapy for Pediatric Brain Tumors. Pract Radiat Oncol 2020; 10:e485-e494. [PMID: 32428764 DOI: 10.1016/j.prro.2020.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/14/2020] [Accepted: 03/09/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE Conventional radiation therapy (RT) to pediatric brain tumors exposes a large volume of normal brain to unwarranted radiation causing late toxicity. We hypothesized that in well demarcated pediatric tumors lacking microscopic extensions, fractionated stereotactic RT (SRT), without target volume expansions, can reduce high dose normal tissue irradiation without affecting local control. METHODS AND MATERIALS Between 2008 and 2017, 52 pediatric patients with brain tumors were treated using the CyberKnife (CK) with SRT in 180 to 200 cGy per fraction. Thirty representative cases were retrospectively planned for intensity modulated RT (IMRT) with 4-mm PTV expansion. We calculated the volume of normal tissue within the high or intermediate dose region adjacent to the target. Plan quality and radiation dose-volume dosimetry parameters were compared between CK and IMRT plans. We also reported overall survival, progression-free survival (PFS), and local control. RESULTS Tumors included low-grade gliomas (n = 28), craniopharyngiomas (n = 16), and ependymomas (n = 8). The volumes of normal tissue receiving high (≥80% of prescription dose or ≥40 Gy) or intermediate (80% > dose ≥50% of the prescription dose or 40 Gy > dose ≥25 Gy) dose were significantly smaller with CK versus IMRT plans (P < .0001 for all comparisons). With a median follow-up of 3.7 years (range, 0.1-9.0), 3-year local control was 92% for all patients. Eight failures occurred: 1 craniopharyngioma (marginal), 2 ependymomas (both in-field), and 5 low-grade gliomas (2 in-field, 1 marginal, and 2 distant). CONCLUSIONS Fractionated SRT using CK without target volume expansion appears to reduce the volume of irradiated tissue without majorly compromising local control in pediatric demarcated brain tumors. These results are hypothesis generating and should be tested and validated in prospective studies.
Collapse
|
7
|
Yang J, Liu G, Liu HY, Nie X, Yang ZY, Han J, Zhang S, Liang ZW. Influence of CyberKnife Prescription Isodose Line on the Discrepancy of Dose Results Calculated by the Ray Tracing and Monte Carlo Algorithms for Head and Lung Plans: A Phantom Study. Curr Med Sci 2020; 40:301-306. [PMID: 32337689 DOI: 10.1007/s11596-020-2177-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/24/2020] [Indexed: 11/29/2022]
Abstract
Incorporation of the Monte Carlo (MC) algorithm in optimizing CyberKnife (CK) plans is cumbersome, and early models unconfgured MC calculations, therefore, this study investigated algorithm-based dose calculation discrepancies by selecting different prescription isodose lines (PIDLs) in head and lung CK plans. CK plans were based on anthropomorphic phantoms. Four shells were set at 2-60 mm from the target, and the constraint doses were adjusted according to the design strategy. After optimization, 30%-90% PIDL plans were generated by ray tracing (RT). In the evaluation module, CK plans were recalculated using the MC algorithm. Therefore, the dosimetric parameters of different PIDL plans based on the RT and MC algorithms were obtained and analyzed. The discrepancies (mean±SD) were 3.72%±0.31%, 3.40%±0.11%, 3.47%±0.32%, 0.17%±0.11%, 0.64%±3.60%, 7.73%±1.60%, 14.62%±3.21% and 10.10%±1.57% for D1%, D(mean), D98% and coverage of the PTV, DGI, V5, V3 and V1 in the head plans and -6.32%±1.15%, -13.46%±0.98%, -20.63%±2.25%, -34.78%±25.03%, 122.48%±175.60%, -12.92%±5.41%, 3.19%±4.67% and 7.13%±1.56% in the lung plans, respectively. The following parameters were signifcantly correlated with PIDL: dD98% at the 0.05 level and dDGI, dV5 and dV3 at the 0.01 level for the head plans; dD98% at the 0.05 level and dD1%, dD(mean), dCoverage, dDGI, dV5 and dV3 at the 0.01 level for the lung plans. RT may be used to calculate the dose in CK head plans, but when the dose of organs at risk is close to the limit, it is necessary to refer to the MC results or to further optimize the CK plan to reduce the dose. For lung plans, the MC algorithm is recommended. For early models without the MC algorithm, a lower PIDL plan is recommended; otherwise, a large PIDL plan risks serious underdosage in the target area.
Collapse
Affiliation(s)
- Jing Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Gang Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Hong-Yuan Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Xin Nie
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Zhi-Yong Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Jun Han
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Sheng Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China
| | - Zhi-Wen Liang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430023, China.
| |
Collapse
|
8
|
Xu Y, Ma P, Xu Y, Dai J. Selection of prescription isodose line for brain metastases treated with volumetric modulated arc radiotherapy. J Appl Clin Med Phys 2019; 20:63-69. [PMID: 31833642 PMCID: PMC6909111 DOI: 10.1002/acm2.12761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/26/2019] [Accepted: 09/23/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose To exploit the optimal prescription isodose line (IDL) for brain metastases treated with volumetric modulated arc radiotherapy (VMAT) as there is no consensus on the selection of IDL with VMAT. Methods and materials Eighteen patients with 20 brain tumors, who were treated with VMAT, were enrolled in this study. For each tumor of every patient, five plans were designed with IDL ranging from 50% to 90% in 10% increments. Different IDLs were obtained through adjusting the constraint parameters during planning optimization. Prescription dose (10 × 5 Gy) were identical for all plans, and the plans were compared in terms of gradient index (GI), conformity Index (CI), V26 Gy/VPTV, and V32 Gy/VPTV in normal brain tissue, which correlate to radiation necrosis. Results IDL with lowest GI has a median value of 60.0% (ranging from 50% to 80%). Except for one tumor with volume larger than 10 cc, the IDL with lowest GI varies from 50% to 70%, which depends on the shape of PTV, location, and whether the target volume is adjacent to crucial OAR. Moreover, there is no significant difference for CI with varying IDL plans. The average V26 Gy/VPTV and V32 Gy/VPTV in normal brain tissue 60% IDL plans are 27.3%, 31.7% lower than 90% IDL plans separately (P < 0.05). However, by further decreasing IDL from 60% to 50%, the average V26 Gy/VPTV and V32 Gy/VPTV may increase comparing with 60% IDL plans (P > 0.05). Furthermore, a lower IDL is found to result in higher mean dose to the target volume (P < 0.05). Conclusions Plans using VMAT with PTV smaller than 10 cc tend to be optimal with IDL around 60–70% for lower GI, smaller V26 Gy/VPTV, V32 Gy/VPTV in normal brain tissue, and higher mean dose in tumor comparing with high IDL plans which have potential benefit in reducing risk of radiation necrosis and increasing the local control. However, IDL lower than 60% is not recommended for the disadvantage of increasing V26 Gy/VPTV and V32 Gy/VPTV in normal brain tissue.
Collapse
Affiliation(s)
- Yuan Xu
- Department of Radiation OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Pan Ma
- Department of Radiation OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yingjie Xu
- Department of Radiation OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jianrong Dai
- Department of Radiation OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| |
Collapse
|
9
|
Ermiş E, Blatti-Moreno M, Leiser D, Cihoric N, Schmidhalter D, Henzen D, Malthaner M, Hemmatazad H, Tsikkinis A, Sermaxhaj B, Aebersold DM, Herrmann E. Dose analysis of InCise 2 multi leaf collimator and IRIS-based stereotactic radiotherapy plans for brain and liver tumors. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab0beb] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|