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Dosimetric Effect of Multileaf Collimator Leaf Width On Volumetric Modulated Arc Stereotactic Radiotherapy for Spine Tumors

A Amoush

A Amoush¹*, L Subedi² , L Huang³ , T Djemil⁴ , P Xia⁵ , (1) Cleveland Clinic Foundation, Cleveland, OH, (2) Cleveland State University, Cleveland, Ohio, (3) Huntsman Cancer Hospital, Salt Lake City, UT, (4) Cleveland Clinic Foundation, Cleveland, OH, (5) Cleveland Clinic, Cleveland, OH

Presentations

SU-E-T-534 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose:To study the dosimetric impact of MLC leaf width in patients treated with Volumetric Modulated Arc Therapy (VMAT) for spine Stereotactic Body radiation Therapy (SBRT).

Methods:Twelve spine SBRT patients were retrospectively selected for this study. The patients were treated with IMRT following the RTOG-0631 of spine metastasis. The prescription dose was 16 Gy in one fraction to 90% of the target volume (V16 > 90%). The maximum spinal cord dose of 14 Gy and 10% of the cord receiving < 10 Gy (V10) were set as dose constraints.
For purpose of this study, three dual arc VMAT plans were created for each patient using three different MLC leaf widths: 2.5 mm, 4mm, and 5mm. The compliance to RTOG 0631, conformal index (CI), dose gradient index (DGI), and number of monitor units (MUs) were compared.


Results:The average V16 of the target was 91.91±1.36%, 93.73±2.38%, and 92.25±2.49% for 2.5 mm, 4 mm, and 5 mm leaf widths, respectively (p=0.39). Accordingly, the average CI was 1.36±0.39, 1.36±0.34, and 1.41±0.3 (0.96), respectively. The average DGI was 0.24 ± 0.05, 0.22 ± 0.05, and 0.23 ± 0.04, respectively (p=0.86).
The average spinal cord maximum dose was 12.10 ± 0.88 Gy, 12.52 ± 1.15 Gy, and 12.05 ± 1.12 (p=0.75) and V10 was 2.69 ± 1.71 cc, 5.43 ± 2.16 cc, and 3.71 ± 2.34 cc (p=0.15) for 2.5 mm, 4 mm, and 5 mm leaf widths, respectively. According, the average number of MUs was 4255 ± 431 MU, 5049 ± 1036 MU, and 4231 ± 580 MU respectively (p=0.17).


Conclusion:The use of 2.5 mm, 4 mm, and 5 mm MLCs achieved similar VMAT plan quality as recommended by RTOG-0631. The dosimetric parameters were also comparable for the three MLCs.


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