Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Parotid gland sparing effect by computed tomography-based modified lower field margin in whole brain radiotherapy

  • Cho, Oyeon (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Chun, Mison (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Park, Sung Ho (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Young-Taek (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Kim, Mi-Hwa (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Park, Hae-Jin (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Nam, Sang Soo (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Heo, Jaesung (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Noh, O Kyu (Department of Radiation Oncology, Ajou University School of Medicine)
  • Received : 2012.10.31
  • Accepted : 2013.01.10
  • Published : 2013.03.31
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Abstract

Purpose: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. Materials and Methods: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). Results: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands ${\geq}20$ Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. Conclusion: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.

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References

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