Radiobiological effect of delivery time in treatments of multiple brain metastases with robotic radiosurgery

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics Pub Date : 2025-08-21 DOI:10.1016/j.ejmp.2025.105087

David Sevillano , Petar Ivaylov , Eva Fernández-Lizarbe , Juan David García , Mercedes Martín , Rafael Morís , Belén Capuz , Rafael Colmenares , Miguel Cámara , Rubén Chillida , Carlos Rodríguez-Manzaneque , Juan Trujillo , María José Béjar , Daniel Prieto , Feliciano García-Vicente

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引用次数: 0

Abstract

Purpose

To analyze the dose effect of the delivery time in CyberKnife Stereotactic Radiosurgery treatments. A prediction tool and methods to minimize this effect are presented.

Methods

Eighty CyberKnife plans of multiple brain metastases (BMs) were analyzed. The Microdosimetric Kinetic Model was used to assess the biological effectiveness of each treatment at each BM. Results were obtained in terms of relative dose (RD) between delivered and planned treatments.

A prediction algorithm of RD was developed by predicting beam delivery times of not yet delivered plans. Two strategies to optimize treatments in terms of biological effectiveness were proposed: beam reordering and treatment splitting.

Results

An average RD of 92.3 % (SD = 2.6 %) was obtained for our patient population. Differences between treated and predicted RD were −0.12 % (SD = 0.6 %). Beam reordering improved RD by a mean value of 5.5 % (SD = 3.3 %) with 17.3 % mean increase in overall treatment time.

Splitted treatments yielded a mean increase of 5.8 % in RD with a time increase of 35 %, while healthy brain was equally spared if treatments were delivered in different days. For those five treatments, an 8.0 % increase in RD and a 20 % increase in treatment time were obtained with reordered beams.

Conclusions

The effect of treatment time on the dose delivered to BMs in SRS with CyberKnife should be taken into consideration, especially when a large number of BMs are involved. This effect can be predicted and minimized by reordering beams at the cost of increasing overall treatment time.

查看原文本刊更多论文

机器人放射手术治疗多发性脑转移瘤中递送时间的放射生物学效应

目的分析射波刀立体定向放射治疗中给药时间的剂量效应。提出了一种预测工具和最小化这种影响的方法。方法对80例多发性脑转移患者的射波刀治疗方案进行分析。微剂量动力学模型用于评估每个BM的每种处理的生物有效性。结果是根据交付和计划治疗之间的相对剂量（RD）获得的。通过对未交付计划的光束交付时间进行预测，提出了一种RD的预测算法。提出了两种优化治疗生物效果的策略：光束重排序和治疗分裂。结果本组患者的平均RD为92.3% （SD = 2.6%）。治疗后RD与预测RD的差异为- 0.12% （SD = 0.6%）。光束重排序使RD平均提高5.5% (SD = 3.3%)，总治疗时间平均增加17.3%。分开治疗的RD平均增加了5.8%，时间增加了35%，而如果在不同的日子进行治疗，健康的大脑同样可以幸免。对于这五种治疗，重排序光束的RD增加了8.0%，治疗时间增加了20%。结论在SRS手术中，尤其是涉及脑转移灶较多的情况下，应考虑治疗时间对脑转移灶给药剂量的影响。这种效应可以通过以增加整体治疗时间为代价对光束进行重新排序来预测和最小化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physica Medica-European Journal of Medical Physics 生物-生物物理

CiteScore

6.80

自引率

14.70%

发文量

493

审稿时长

78 days

期刊介绍： Physica Medica, European Journal of Medical Physics, publishing with Elsevier from 2007, provides an international forum for research and reviews on the following main topics: Medical Imaging Radiation Therapy Radiation Protection Measuring Systems and Signal Processing Education and training in Medical Physics Professional issues in Medical Physics.