Initial experience with volumetric IMRT (RapidArc) for intracranial stereotactic radiosurgery.

Abstract

Initial experience with delivering frameless stereotactic radiotherapy (SRT) using volumetric intensity-modulated radiation therapy (IMRT) delivered with RapidArc is presented. Treatment details for 12 patients (14 targets) with a mean clinical target volume (CTV) of 12.8 ± 4.0 cm(3) were examined. Dosimetric indices for conformality, homogeneity, and dose gradient were calculated and compared with published results for other frameless, intracranial SRT techniques, including CyberKnife, TomoTherapy, and static-beam IMRT. Statistics on setup and treatment times and per patient dose validations were examined. Dose indices compared favorably with other techniques. Mean conformality, gradient, and homogeneity index values were 1.10 ± 0.11, 64.9 ± 14.1, 1.083 ± 0.026, respectively. Median treatment times were 4.8 ± 1.7 min. SRT using volumetric IMRT is a viable alternative to other techniques and enables short treatment times. This is anticipated to have a positive impact on radiobiological effect and for facilitating wider use of SRT.