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Clinical Experience in Conformal Stereotactic Radiotherapy of Irregularly Shaped Intracranial Tumors
Ki-Hwan Kim,Moon-JuneCho,Dong-WukKim,Jun-SangKim,Seon-HwanKim,Shi-HunSong,Ji-YoungJang,Jae-SungKim,Chang-JoonSong 대한암학회 2003 Cancer Research and Treatment Vol.35 No.1
Purpose: The dosimetric advantages of multiple noncoplanarstationary fields for stereotactic radiotherapyor radiosurgery (SRT/S) are well known. However, thistechnique is not widely used due to the logistical problemsassociated with producing and testing customizedcollimators. We report our experience of SRT/Susing multiple non-coplanar stationary fields (conformalSRT/ S).Materials and Methods: Between August 1997 andFebruary 2002, we performed frameless SRT/S in 63patients. We chose conformal SRT/S when the tumor wasof a very irregular shape or larger than 4 cm. We obtainedthree pieces of information: 1) the couch translationsrequired to bring the target point to the isocenter, 2) thedistance between the stereotaxic markers in the CTstudy, and the distance between the markers determinedfrom orthogonal beam films, taken in the anterior- posteriorand lateral directions, and 3) the rotational movementof thehead position between the CT study and actualtreatment position. W e evaluated two kinds of data:1) the precision of the isocenter setup, and 2) thereproducibility of the head position in the a) translationaland b) rotational components.Results: Twenty-six of the 63 patients receiving stereotactictreatment received conformal SRT/S. The precisionof the isocenter setup for the conformal SRT/S wasx=-0.03±0.26 mm, y=0.19±0.25 mm and z=-0.20 ±0.27mm. The reproducibilities of the head position with theconformal SRT/S were 0.5 mm and less than 1o, for thetranslational and rotational components, in any plane.Conclusion: We were able to apply conformal stereotacticirradiation, which has a dosimetric advantage, toirregularly shaped intracranial tumors, with precision andreproducibility of head position for the isocenter setupnearly equivalent to that of frame-based SRS or multiple-arc SRT/S. (Cancer Res Treat. 2003;35:69-74)