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KMID : 1038620130310010012
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Radiation Oncology Journal
2013 Volume.31 No. 1 p.12 ~ p.17
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Parotid gland sparing effect by computed tomography-based modified lower field margin in whole brain radiotherapy
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Cho O-Yeon
Chun Mi-Son
Park Sung-Ho
Oh Young-Taek
Kim Mi-Hwa
Park Hae-Jin
Nam Sang-Soo
Heo Jae-Sung
Noh O-Kyu
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Abstract
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Purpose: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. Materials and Methods: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). Results: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands ≥20 Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. Conclusion: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.
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KEYWORD
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Whole brain radiotherapy, Parotid gland sparing, Xerostomia, Normal tissue complication probability
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