Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases

Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to...
Ausführliche Beschreibung

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Autor*in:	Kornhuber, Christine [verfasserIn] Ensminger, Stephan Hübsch, Patrick Janich, Martin Leucht, Chris Andre Vordermark, Dirk Dietzel, Christian T.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Brain metastases Hypofractionated stereotactic radiotherapy Simultaneously integrated boost

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Radiation oncology - London : BioMed Central, 2006, 18(2023), 1 vom: 22. Mai
Übergeordnetes Werk:	volume:18 ; year:2023 ; number:1 ; day:22 ; month:05

Links:	Volltext

DOI / URN:	10.1186/s13014-023-02266-9

Katalog-ID:	SPR051591685

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520			\|a Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use.
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700	1		\|a Leucht, Chris Andre \|4 aut
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700	1		\|a Dietzel, Christian T. \|4 aut
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allfields	10.1186/s13014-023-02266-9 doi (DE-627)SPR051591685 (SPR)s13014-023-02266-9-e DE-627 ger DE-627 rakwb eng Kornhuber, Christine verfasserin aut Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. Brain metastases (dpeaa)DE-He213 Hypofractionated stereotactic radiotherapy (dpeaa)DE-He213 Simultaneously integrated boost (dpeaa)DE-He213 Ensminger, Stephan aut Hübsch, Patrick aut Janich, Martin aut Leucht, Chris Andre aut Vordermark, Dirk aut Dietzel, Christian T. aut Enthalten in Radiation oncology London : BioMed Central, 2006 18(2023), 1 vom: 22. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:18 year:2023 number:1 day:22 month:05 https://dx.doi.org/10.1186/s13014-023-02266-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 22 05
spelling	10.1186/s13014-023-02266-9 doi (DE-627)SPR051591685 (SPR)s13014-023-02266-9-e DE-627 ger DE-627 rakwb eng Kornhuber, Christine verfasserin aut Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. Brain metastases (dpeaa)DE-He213 Hypofractionated stereotactic radiotherapy (dpeaa)DE-He213 Simultaneously integrated boost (dpeaa)DE-He213 Ensminger, Stephan aut Hübsch, Patrick aut Janich, Martin aut Leucht, Chris Andre aut Vordermark, Dirk aut Dietzel, Christian T. aut Enthalten in Radiation oncology London : BioMed Central, 2006 18(2023), 1 vom: 22. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:18 year:2023 number:1 day:22 month:05 https://dx.doi.org/10.1186/s13014-023-02266-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 22 05
allfields_unstemmed	10.1186/s13014-023-02266-9 doi (DE-627)SPR051591685 (SPR)s13014-023-02266-9-e DE-627 ger DE-627 rakwb eng Kornhuber, Christine verfasserin aut Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. Brain metastases (dpeaa)DE-He213 Hypofractionated stereotactic radiotherapy (dpeaa)DE-He213 Simultaneously integrated boost (dpeaa)DE-He213 Ensminger, Stephan aut Hübsch, Patrick aut Janich, Martin aut Leucht, Chris Andre aut Vordermark, Dirk aut Dietzel, Christian T. aut Enthalten in Radiation oncology London : BioMed Central, 2006 18(2023), 1 vom: 22. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:18 year:2023 number:1 day:22 month:05 https://dx.doi.org/10.1186/s13014-023-02266-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 22 05
allfieldsGer	10.1186/s13014-023-02266-9 doi (DE-627)SPR051591685 (SPR)s13014-023-02266-9-e DE-627 ger DE-627 rakwb eng Kornhuber, Christine verfasserin aut Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. Brain metastases (dpeaa)DE-He213 Hypofractionated stereotactic radiotherapy (dpeaa)DE-He213 Simultaneously integrated boost (dpeaa)DE-He213 Ensminger, Stephan aut Hübsch, Patrick aut Janich, Martin aut Leucht, Chris Andre aut Vordermark, Dirk aut Dietzel, Christian T. aut Enthalten in Radiation oncology London : BioMed Central, 2006 18(2023), 1 vom: 22. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:18 year:2023 number:1 day:22 month:05 https://dx.doi.org/10.1186/s13014-023-02266-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 22 05
allfieldsSound	10.1186/s13014-023-02266-9 doi (DE-627)SPR051591685 (SPR)s13014-023-02266-9-e DE-627 ger DE-627 rakwb eng Kornhuber, Christine verfasserin aut Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. Brain metastases (dpeaa)DE-He213 Hypofractionated stereotactic radiotherapy (dpeaa)DE-He213 Simultaneously integrated boost (dpeaa)DE-He213 Ensminger, Stephan aut Hübsch, Patrick aut Janich, Martin aut Leucht, Chris Andre aut Vordermark, Dirk aut Dietzel, Christian T. aut Enthalten in Radiation oncology London : BioMed Central, 2006 18(2023), 1 vom: 22. Mai (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:18 year:2023 number:1 day:22 month:05 https://dx.doi.org/10.1186/s13014-023-02266-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 1 22 05
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source	Enthalten in Radiation oncology 18(2023), 1 vom: 22. Mai volume:18 year:2023 number:1 day:22 month:05
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However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. 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author	Kornhuber, Christine
spellingShingle	Kornhuber, Christine misc Brain metastases misc Hypofractionated stereotactic radiotherapy misc Simultaneously integrated boost Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
authorStr	Kornhuber, Christine
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topic_title	Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases Brain metastases (dpeaa)DE-He213 Hypofractionated stereotactic radiotherapy (dpeaa)DE-He213 Simultaneously integrated boost (dpeaa)DE-He213
topic	misc Brain metastases misc Hypofractionated stereotactic radiotherapy misc Simultaneously integrated boost
topic_unstemmed	misc Brain metastases misc Hypofractionated stereotactic radiotherapy misc Simultaneously integrated boost
topic_browse	misc Brain metastases misc Hypofractionated stereotactic radiotherapy misc Simultaneously integrated boost
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title	Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
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title_full	Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
author_sort	Kornhuber, Christine
journal	Radiation oncology
journalStr	Radiation oncology
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author_browse	Kornhuber, Christine Ensminger, Stephan Hübsch, Patrick Janich, Martin Leucht, Chris Andre Vordermark, Dirk Dietzel, Christian T.
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author-letter	Kornhuber, Christine
doi_str_mv	10.1186/s13014-023-02266-9
title_sort	feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
title_auth	Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
abstract	Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. © The Author(s) 2023
abstractGer	Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. © The Author(s) 2023
abstract_unstemmed	Background In stereotactic radiotherapy, dose is prescribed to an isodose surrounding the planning target volume (PTV). However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. Conclusion Our stereotactic SIB concept better defines the dose distribution inside PTV and can be considered for clinical use. © The Author(s) 2023
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title_short	Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases
url	https://dx.doi.org/10.1186/s13014-023-02266-9
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author2	Ensminger, Stephan Hübsch, Patrick Janich, Martin Leucht, Chris Andre Vordermark, Dirk Dietzel, Christian T.
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up_date	2024-07-03T22:42:54.846Z
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However, the desired dose inhomogeneity inside the PTV leaves the specific dose distribution to the gross tumor volume (GTV) unspecified. A simultaneously integrated boost (SIB) to the GTV could solve this shortcoming. In a retrospective planning study with 20 unresected brain metastases, a SIB approach was tested against the classical prescription. Methods For all metastases, the GTV was isotropically enlarged by 3 mm to a PTV. Two plans were generated, one according to the classical 80% concept with 5 times 7 Gy prescribed (on $ D_{2%} $) to the 80% PTV surrounding isodose (with $ D_{98%} $(PTV) ≥ 35 Gy), and the other one following a SIB concept with 5 times 8.5 Gy average GTV dose and with $ D_{98%} $(PTV) ≥ 35 Gy as additional requirement. Plan pairs were compared in terms of homogeneity inside GTV, high dose in PTV rim around GTV, and dose conformity and gradients around PTV using Wilcoxon matched pairs signed rank test. Results The SIB concept was superior to the classical 80% concept concerning dose homogeneity inside GTV: Heterogeneity index of GTV was in the SIB concept (median 0.0513, range 0.0397–0.0757) significantly (p = 0.001) lower than in the 80% concept (median 0.0894, range 0.0447–0.1872). Dose gradients around PTV were not inferior. The other examined measures were comparable. 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Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases

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