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Zhu L, Dong S, Sun L, Xiao Y, Zhong Y, Pan M, Wang Y. Dosimetric comparison of HyperArc and InCise MLC-based CyberKnife plans in treating single and multiple brain metastases. J Appl Clin Med Phys 2024; 25:e14404. [PMID: 38803034 PMCID: PMC11302820 DOI: 10.1002/acm2.14404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/19/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to compare the dosimetric attributes of two multi-leaf collimator based techniques, HyperArc and Incise CyberKnife, in the treatment of brain metastases. MATERIAL AND METHODS 17 cases of brain metastases were selected including 6 patients of single lesion and 11 patients of multiple lesions. Treatment plans of HyperArc and CyberKnife were designed in Eclipse 15.5 and Precision 1.0, respectively, and transferred to Velocity 3.2 for comparison. RESULTS HyperArc plans provided superior Conformity Index (0.91 ± 0.06 vs. 0.77 ± 0.07, p < 0.01) with reduced dose distribution in organs at risk (Dmax, p < 0.05) and lower normal tissue exposure (V4Gy-V20Gy, p < 0.05) in contrast to CyberKnife plans, although the Gradient Indexes were similar. CyberKnife plans showed higher Homogeneity Index (1.54 ± 0.17 vs. 1.39 ± 0.09, p < 0.05) and increased D2% and D50% in the target (p < 0.05). Additionally, HyperArc plans had significantly fewer Monitor Units (MUs) and beam-on time (p < 0.01). CONCLUSION HyperArc plans demonstrated superior performance compared with MLC-based CyberKnife plans in terms of conformity and the sparing of critical organs and normal tissues, although no significant difference in GI outcomes was noted. Conversely, CyberKnife plans achieved a higher target dose and HI. The study suggests that HyperArc is more efficient and particularly suitable for treating larger lesions in brain metastases.
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Affiliation(s)
- Liying Zhu
- Radiation Oncology CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Shengnan Dong
- Radiation Oncology CenterHenan Province Hospital of TCMZhengzhouChina
| | - Lei Sun
- Department of NeurosurgeryCyberKnife CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Yixuan Xiao
- Radiation Oncology CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Yihua Zhong
- Radiation Oncology CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Mingyuan Pan
- Radiation Oncology CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Yang Wang
- Radiation Oncology CenterHuashan HospitalFudan UniversityShanghaiChina
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Knill C, Loughery B, Sandhu R. Dosimetric Effects of Dynamic Jaw Tracking and Collimator Angle Optimization in Non-Coplanar Cranial Arc Radiotherapy. Med Dosim 2023:S0958-3947(23)00027-4. [PMID: 37095041 DOI: 10.1016/j.meddos.2023.03.006] [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: 11/16/2022] [Revised: 02/03/2023] [Accepted: 03/14/2023] [Indexed: 04/26/2023]
Abstract
The stereotactic treatment of single cranial targets using noncoplanar volumetric modulated arc therapy (VMAT) allows for effective dose delivery to the target, while sparing normal brain tissue. In this study, the dosimetric effect of adding dynamic jaw tracking and automatic collimator angle selection in the optimization of single target cranial VMAT plans was investigated. Twenty-two cranial targets, previously treated with VMAT without dynamic jaw tracking and automatic collimator angle optimization (CAO) were chosen for replanning. Target volumes ranged from 0.441cc to 25.863cc with doses between 18Gy and 30Gy delivered in 1 to 5 fractions. Original plans were reoptimized with automatic CAO, keeping all other objectives the same (CAO plans). Next, original plans were reoptimized with both dynamic jaw tracking and CAO (DJT plans). Original, CAO, and DJT target doses were compared using the Paddick gradient index (GI) and the Paddick inverse conformity index (ICI), while normal tissue dose was compared using the volume of the normal brain receiving 5Gy, 10Gy, and 12Gy. The normal tissue volume was normalized to target size to allow cross comparison between plans. A one-sided t-test was performed to determine whether the changes in the plan metrics were statistically significant. CAO plans had improved GIs compared to the originals (p = 0.03) with insignificant changes in other plan metrics (p > 0.20). The addition of dynamic jaw tracking in DJT plans greatly improved ICIs and normal brain metrics (p < 0.01) compared to the CAO plans with minor improvement in ICIs (p = 0.07). The combined effect of adding dynamic jaw tracking and collimator optimization led to improvements in all metrics of the DJT plans when compared to the original (p < 0.02). The addition of dynamic jaw tracking and CAO led to improvements in both target and normal tissue dose metrics for single-target noncoplanar cranial VMAT plans.
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Affiliation(s)
- Cory Knill
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan 48073, USA.
| | - Brian Loughery
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan 48073, USA.
| | - Raminder Sandhu
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan 48073, USA.
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Chan M, Gevaert T, Kadoya N, Dorr J, Leung R, Alheet S, Toutaoui A, Farias R, Wong M, Skourou C, Valenti M, Farré I, Otero-Martínez C, O'Doherty D, Waldron J, Hanvey S, Grohmann M, Liu H. Multi-center planning study of radiosurgery for intracranial metastases through Automation (MC-PRIMA) by crowdsourcing prior web-based plan challenge study. Phys Med 2022; 95:73-82. [DOI: 10.1016/j.ejmp.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/10/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022] Open
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Shiomi H, Akino Y, Sumida I, Masai N, Oh RJ, Ogawa K. Development of raster scanning IMRT using a robotic radiosurgery system. JOURNAL OF RADIATION RESEARCH 2021; 62:364-373. [PMID: 33454766 PMCID: PMC7948854 DOI: 10.1093/jrr/rraa136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Treatment time with the CyberKnife frameless radiosurgery system is prolonged due to the motion of the robotic arm. We have developed a novel scanning irradiation method to reduce treatment time. We generated treatment plans mimicking eight-field intensity-modulated radiotherapy (IMRT) plans generated for the Novalis radiosurgery system. 2D dose planes were generated with multiple static beam spots collimated by a fixed circular cone. The weights of the uniformly distributed beam spots in each dose plane were optimized using the attraction-repulsion model. The beam spots were converted to the scanning speed to generate the raster scanning plan. To shorten treatment time, we also developed a hybrid scanning method which combines static beams with larger cone sizes and the raster scanning method. Differences between the Novalis and the scanning plan's dose planes were evaluated with the criterion of a 5% dose difference. The mean passing rates of three cases were > 85% for cone sizes ≤ 12.5 mm. Although the total monitor units (MU) increased for smaller cone sizes in an inverse-square manner, the hybrid scanning method greatly reduced the total MU, while maintaining dose distributions comparable to those with the Novalis plan. The estimated treatment time of the hybrid scanning with a 12.5 mm cone size was on average 22% shorter than that of the sequential plans. This technique will be useful in allowing the CyberKnife with conventional circular cones to achieve excellent dose distribution with a shortened treatment time.
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Affiliation(s)
- Hiroya Shiomi
- Miyakojima IGRT Clinic, Miyakojima-ku, Osaka 534-0021, Japan
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
- Soseikai Clinic CyberKnife Center, Fushimi, Kyoto 612-8248, Japan
- RADLab Inc., Kawachinagano, Osaka 586-0092, Japan
| | - Yuichi Akino
- Soseikai Clinic CyberKnife Center, Fushimi, Kyoto 612-8248, Japan
- Oncology Center, Osaka University Hospital, Suita, Osaka 565-0871, Japan
| | - Iori Sumida
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Norihisa Masai
- Department of Radiology, North Medical Center Kyoto Prefectural University of Medicine, Yosano-cho, Yosa-gun, Kyoto 629-2261, Japan
| | - Ryoong-Jin Oh
- Miyakojima IGRT Clinic, Miyakojima-ku, Osaka 534-0021, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
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Taylor M, Williams J, Gleason JF. Effects of Multileaf Collimator Design and Function When Using an Optimized Dynamic Conformal Arc Approach for Stereotactic Radiosurgery Treatment of Multiple Brain Metastases With a Single Isocenter: A Planning Study. Cureus 2020; 12:e9833. [PMID: 32832305 PMCID: PMC7437117 DOI: 10.7759/cureus.9833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/17/2020] [Indexed: 12/11/2022] Open
Abstract
Background Stereotactic radiosurgery (SRS) or fractionated SRS (fSRS) are effective options for the treatment of brain metastases. When treating multiple metastases with a linear accelerator-based approach, a single isocenter allows for efficient treatment delivery. In this study, we present our findings comparing dosimetric parameters of Brainlab (Munich, Germany) Elements™ Multiple Brain Mets SRS (MME) software (version 1.5 versus version 2.0) for a variety of scenarios and patients. The impact of multileaf collimator design and function on plan quality within the software was also evaluated. Materials and methods Twenty previously treated patients with a total of 58 lesions (from one to seven lesions each) were replanned with an updated version of the multiple brain Mets software solution. For each plan, the mean conformity index (CI), mean gradient index (GI), the volume of normal brain receiving 12 Gy (V12), and mean brain dose were evaluated. Additionally, all v2.0 plans were further evaluated with jaw tracking for by Elekta (Stockholm, Sweden) and HD120™ multileaf collimator by Varian Medical Systems (Palo Alto, USA). Results The new software version demonstrated improvements for CI, GI and V12 (p <0.01). For the Elekta Agility™ multileaf collimator, jaw tracking improved all dosimetric parameters except for CI (p =0.178) and mean brain dose (p =0.93). For the Varian with HD120 multileaf collimator, all parameters improved. Conclusions The software enhancements in v2.0 of the software provided improvements in planning efficiency and dosimetric parameters. Differences in multileaf collimator design may provide an additional incremental benefit in a subset of clinical scenarios.
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Affiliation(s)
| | | | - John F Gleason
- Radiation Oncology, Alliance Cancer Care, Huntsville, USA
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Calusi S, Doro R, Di Cataldo V, Cipressi S, Francolini G, Bonucci I, Livi L, Masi L. Performance assessment of a new optimization system for robotic SBRT MLC-based plans. Phys Med 2020; 71:31-38. [DOI: 10.1016/j.ejmp.2020.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 12/14/2022] Open
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Murai T, Matsuo M, Tanaka H, Manabe Y, Takaoka T, Hachiya K, Yamaguchi T, Otsuka S, Shibamoto Y. Efficacy of herbal medicine TJ-14 for acute radiation-induced enteritis: a multi-institutional prospective Phase II trial. JOURNAL OF RADIATION RESEARCH 2020; 61:140-145. [PMID: 31691810 PMCID: PMC7022136 DOI: 10.1093/jrr/rrz025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/29/2019] [Indexed: 05/11/2023]
Abstract
The purpose of this multi-institutional Phase II trial study was to prospectively investigate the efficacy of the herbal medicine TJ-14 for acute radiation-induced enteritis (ARE). TJ-14 was administered orally as a first-line treatment for ARE. The primary end point was efficacy at 1 week. The secondary end points were: (i) the efficacy of TJ-14 at 2 and 3 weeks after its administration, (ii) the quality of life score (FACT-G) at 1, 2 and 3 weeks after its administration, and (iii) adverse events. If the efficacy of TJ-14 was observed in eight patients or fewer, its efficacy was rejected. Results: Forty patients receiving pelvic radiotherapy were enrolled. Of these, 22 developed ARE and received TJ-14. Among these, 19 had cervical cancer and 9 received chemoradiotherapy. TJ-14 efficacy was shown in 19 out of the 22 patients (86%). Stool frequency per day at 1 week significantly decreased (mean ± SD: 4.9 ± 2.1 vs 3.7 ± 1.9, P = 0.02). This effect continued at 2 (2.2 ± 1.4, P = 0.004) and 3 weeks (2.1 ± 0.9, P = 0.05). Thirteen out of the 22 patients (59%) continued TJ-14 until the end of radiotherapy. FACT-G score deterioration was not observed after the administration of TJ-14. Grade 1 hypokalemia was observed in 4 patients, and Grade 1 constipation in 3. We concluded that TJ-14 is sufficiently promising to be examined in a Phase III trial. A randomized controlled trial is currently being planned.
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Affiliation(s)
- Taro Murai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Corresponding author. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Tel: +81-52–853-8276; Fax: +81-52–852-5244;
| | - Masayuki Matsuo
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Radiation Oncology, Gifu University Graduate School of Medical Sciences, Gifu, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Gifu University Graduate School of Medical Sciences, Gifu, Japan
| | - Yoshihiko Manabe
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Taiki Takaoka
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Radiology, Japan Community Healthcare Organization (JCHO) Chukyo Hospital, Nagoya, Japan
| | - Kae Hachiya
- Department of Radiation Oncology, Gifu University Graduate School of Medical Sciences, Gifu, Japan
| | - Takahiro Yamaguchi
- Department of Radiation Oncology, Gifu University Graduate School of Medical Sciences, Gifu, Japan
| | - Shinya Otsuka
- Department of Radiology, Okazaki City Hospital, Okazaki, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Murai T, Tamura T, Nakabayashi T, Ito H, Manabe Y, Murata R, Niwa M, Shibamoto Y. Clinical Evaluation of Onrad, A New Low-cost Version of TomoTherapy that Uses Only Static Beams. Kurume Med J 2020; 65:129-136. [PMID: 31723077 DOI: 10.2739/kurumemedj.ms654004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study evaluated the clinical feasibility of a new low-cost TomoTherapy system (OnradTM) and compared it with low-cost linear accelerator models (linacs). METHODS Various aspects of treatment and cost were compared between Onrad and linacs for 3-dimensional radiotherapy (3DCRT). Dosimetric comparisons of 10 patients each with breast, stage III lung, prostate, head and neck, and cervical cancers were carried out (total 100 plans). RESULTS Onrad had advantages in terms of availability of long treatment fields and a smaller mechanical footprint. For breast cancers and lung cancers, target dose homogeneity in Onrad plans was better than that in 3DCRT. In the prostate plans, Onrad plans provided superior D95, conformity and homogeneity. The rectum doses of Onrad plans were lower than those with 3DCRT. Onrad plans provided superior homogeneity and D95 in head and neck cancer. The mean dose and V10-40 Gy of the parotid glands was lower using Onrad. In the cervical cancer plans, target doses were similar with both systems. Normal tissue doses were equal. CONCLUSIONS Onrad is useful in the clinical setting. Onrad can achieve favorable or comparable dose distributions compared with those of 3DCRT in actual clinical treatment of breast, lung, prostate, head and neck, and cervical cancers.
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Affiliation(s)
- Taro Murai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences.,Department of Radiation Oncology, JA Suzuka General Hospital
| | - Takeshi Tamura
- Department of Radiation Oncology, JA Suzuka General Hospital.,Department of Radiation Oncology, Tatebayashi Kosei Hospital
| | | | - Hiroya Ito
- Department of Radiation Oncology, JA Suzuka General Hospital
| | - Yoshihiko Manabe
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences.,Department of Radiation Oncology, Nanbu Tokushukai Hospital
| | - Rumi Murata
- Department of Radiation Oncology, JA Suzuka General Hospital
| | - Masanari Niwa
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences.,Department of Radiation Oncology, JA Suzuka General Hospital
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences
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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]
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10
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Hoshina RM, Matsuura T, Umegaki K, Shimizu S. A Literature Review of Proton Beam Therapy for Prostate Cancer in Japan. J Clin Med 2019; 8:jcm8010048. [PMID: 30621278 PMCID: PMC6352078 DOI: 10.3390/jcm8010048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/23/2018] [Accepted: 12/28/2018] [Indexed: 12/14/2022] Open
Abstract
Aim: Patients of proton beam therapy (PBT) for prostate cancer had been continuously growing in number due to its promising characteristics of high dose distribution in the tumor target and a sharp distal fall-off. Considering the large number of proton beam facilities in Japan, the further increase of patients undergoing this treatment is due to the emendations by Japanese National Health Insurance (NHI) and the development of medical equipment and technology, it is necessary to know what kind of research and advancements has been done on proton therapy for prostate cancer in the country. For these reasons, this literature review was conducted. The aim of this review is to identify and discuss research studies of proton beam therapy for prostate cancer in Japan. These include observational, interventional, and secondary data analysis of published articles. Method: A literature review on published works related to proton beam therapy for prostate cancer in Japan was conducted using articles that were gathered in the PubMed database of June 2018. We went through abstracts and manuscripts written in English with the keywords ‘proton beam therapy’, ‘prostate cancer’, and ‘Japan’. Results: A total of 23 articles were included. Fourteen articles were observational studies, most of which focused on the adverse effects of Proton Beam Therapy (PBT). Seven articles were interventional studies related on treatment planning, equipment parts, as well as target positioning. Two were secondary data analysis. The included studies were published in 13 different journals by different institutions using various equipment. Conclusion: Despite the favorable results of proton beam therapy, future research should include more patients and longer follow-up schedules to clarify the definitive role of PBT, yet, up to recent retrospective studies, included in this paper, concluded that PBT can be a suitable treatment option for localized prostate cancer. In addition, interventional studies were conducted by several institutions to further embellish proton therapy.
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Affiliation(s)
- Rika Maglente Hoshina
- Faculty of Medicine and Surgery, University of Santo Tomas, España, Manila 1002, Philippines.
| | - Taeko Matsuura
- Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo 060-8648, Japan.
- Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo 060-8638, Japan.
- Division of Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Sapporo 060-8628, Japan.
| | - Kikuo Umegaki
- Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo 060-8648, Japan.
- Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo 060-8638, Japan.
- Division of Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Sapporo 060-8628, Japan.
| | - Shinichi Shimizu
- Proton Beam Therapy Center, Hokkaido University Hospital, Sapporo 060-8648, Japan.
- Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo 060-8638, Japan.
- Department of Radiation Oncology, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
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CyberKnife MLC-based treatment planning for abdominal and pelvic SBRT: Analysis of multiple dosimetric parameters, overall scoring index and clinical scoring. Phys Med 2018; 56:25-33. [DOI: 10.1016/j.ejmp.2018.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/13/2018] [Accepted: 11/17/2018] [Indexed: 12/31/2022] Open
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