Comprehensive Commissioning and Clinical Implementation of GammaTiles STaRT for Intracranial Brain Cancer.

Autor:	Penoncello GP; Departments of Radiation Oncologya, Mayo Clinic Cancer Center, Phoenix, Arizona., Gagneur JD; Departments of Radiation Oncologya, Mayo Clinic Cancer Center, Phoenix, Arizona., Vora SA; Departments of Radiation Oncologya, Mayo Clinic Cancer Center, Phoenix, Arizona., Yu NY; Departments of Radiation Oncologya, Mayo Clinic Cancer Center, Phoenix, Arizona., Fatyga M; Departments of Radiation Oncologya, Mayo Clinic Cancer Center, Phoenix, Arizona., Mrugala MM; Department of Neurology and Medical Oncology, Mayo Clinic Cancer Center, Phoenix, Arizona., Bendok BR; Department of Neurosurgery, Mayo Clinic Cancer Center, Phoenix, Arizona., Rong Y; Departments of Radiation Oncologya, Mayo Clinic Cancer Center, Phoenix, Arizona.
Jazyk:	angličtina
Zdroj:	Advances in radiation oncology [Adv Radiat Oncol] 2022 Feb 05; Vol. 7 (4), pp. 100910. Date of Electronic Publication: 2022 Feb 05 (Print Publication: 2022).
DOI:	10.1016/j.adro.2022.100910
Abstrakt:	Purpose: To validate the dose calculation accuracy and dose distribution of GammaTiles for brain tumors, and to suggest a surgically targeted radiation therapy (STaRT) workflow for planning, delivery, radiation safety documentation, and posttreatment validation. Methods and Materials: Novel surgically targeted radiation therapy, GammaTiles, uses Cs-131 radiation isotopes embedded in collagen-based tiles that can be resorbed after surgery. GammaTile target delineation and dose calculation were performed on MIM Symphony software. Point-based and complex seed distribution calculations in MIM Symphony were verified with hand calculations and BrachyVision calculations. Vendor-provided 2-dimensional dose distribution calculation accuracy was validated using gafchromic EBT3 film measurements at various depths. A workflow was established for safe and effective GammaTile implants. Results: Good agreement was observed between different calculations. Calculation accuracy of less than 0.5% was achieved for all points except one, which had rounding issues for very low doses and resulted in just below 5% difference. Differences in anisotropy and geometry positioning were noticed in the delineation of Cs-131 IsoRay seeds in the compared systems, resulting in minor discrepancies in the calculated dosimetry distributions. Film measurements showed profiles with relatively good agreement of 0% to 5% in nongradient regions with higher differences between 5% to 10% in the sharp dose fall-off regions. Conclusions: A comprehensive evaluation of GammaTile geometry, dose distribution, and clinical workflow was conducted. Safe intro-operative implantation of GammaTiles requires extensive preplanning and interdisciplinary collaboration. A STaRT workflow was outlined to provide a guideline for an accurate treatment planning and safe implant process at other institutions. (© 2022 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu