Mathews Journal of Cancer Science


Previous Issues Volume 4, Issue 2 - 2019

The Impact of Normalization Isodose Line (NIDL) on Dose Distribution in Intracranial Tumors Treated with CyberKnife

Zhitao Dai1, Cui Yang2,3, Wei Jiang1, Man Zhao1, Weigang Hu2,3, and Hua Ren1*

1National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China

2School of Physics and Technology, Wuhan University, China

3Department of Radiation Oncology, Fudan University, Shanghai Cancer Center, China

*Corresponding Author: Hua Ren, Department of Radiation Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, China, E-mail: [email protected]

Copyright © 2019 Ren H, et al.

Citation: Ren H. (2019). The Impact of Normalization Isodose Line (NIDL) on Dose Distribution in Intracranial Tumors Treated with CyberKnife. Mathews J Cancer Sci. 4(2): 23



Objective: Dosimetric characteristics and dose falloff variation of Cyberknife (CK) plans under different isodose lines (IDL) of head tumors were assessed in an attempt to provide reference for clinical radiotherapy treatment planning.

Methods: Ten head tumor patients planned with stereotactic body radiotherapy (SBRT) were selected and replanned, uniformly meeting the same objective with 30Gy covering 95% of the planning target volume (PTV). Four separate plans normalized to 65%, 70%, 75%, 80% IDL respectively were generated for each case. Dose distribution outcomes were compared using dosimetric parameters, including dose-volume histogram (DVH), conformal index (CI), new conformal index (nCI), homogeneity index (HI) and dose gradient index (GI).

Results: Plans normalized to a higher percentage provide a better dose conformation of the prescription dose envelop and PTV homogeneity. As the normalized percentage changes from 80% to 65%, CI changes from 1.16 to 1.24, nCI changes from 1.18 to 1.28, HI changes from 0.25 to 0.54. In addition, GI is defined as the difference between the effective radius of the package volumes of 50% and 100% IDL. For the plans normalized to 65%, 70%, 75%, and 80% IDL, GI values are 6.89 ± 2.60, 7.17 ± 2.72, 7.33 ± 2.84, and 7.57 ± 2.95 respectively. Moreover, it increases as the tumor volume increases.

Conclusion: For SBRT treatment planning, a lower normalized percentage can achieve a better protection of normal tissue, while a higher normalized percentage will result in a greater conformity and homogeneity of dose distribution. Moreover, for different volumes of head tumor, comprehensive consideration should be given to the radiotherapy treatment planning, in order to improve the therapeutic ratio.

Keywords: Cyberknife treatment plan; Normalized isodose line; Dose gradient.

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