Dosimetric Comparison of Simultaneous Integrated vs. Sequential Boost in Radiotherapy for High Grade Gliomas

Despite of the use of combined treatment modalities including surgery, radiotherapy, and chemotherapy for the management of high-grade gliomas, the prognosis is still poor with a median survival of 14.6 months following combined treatment [1]. These tumours exhibit an infiltrative growth and it is necessary to control the peripheral infiltrating parts of microscopic tumor, which is usually not visible on imaging, as well as the visible tumor on diagnostic imaging. Therefore, it very important to target both areas with deliver different dose levels trying to spare the critical structures while maximize the dose to the area at risk [2-7]. Intensity modulated radiotherapy (IMRT) is advantageous owing to its better dose distribution and better sparing of normal tissues when compared with traditional 3D radiation treatment [8-11]. Volumetric-modulated arc therapy (VMAT) is a special kind of rotational IMRT [12]. In VMAT during rotation of the gantry, the dose rate and shape Abstract