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Lookup NU author(s): Dr Helen Lucraft
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Craniospinal irradiation is technically demanding due to the complex shape of the planning target volume (PTV). Radiotherapy treatment techniques have evolved overtime as imaging and radiotherapy treatment technology have improved. However, most are variations on a class solution utilizing a prone patient position with two shaped lateral cranial portals and a matched posterior spinal portal with moving junctions. Major areas of difficulty remain with the accurate definition of the PTV and achieving a homogeneous dose within it, especially at the junctions. We describe a three-dimensionally (3D) planned craniospinal radiation technique that permits rapid image acquisition with reduced localization time, simplified spinal PTV definition and standardized cranial PTV definition. Improved dose homogeneity within the PTV is achieved by use of a segmented "field-in-field" technique (forward planned intensity-modulated radiotherapy (IMRT)) in place of customized compensators. This has negated the requirement for constructing physical compensators. Autosequencing for field delivery enables the junction to be "moved" during a single fraction and reduces the overall treatment time, an important consideration when treating very young patients.
Author(s): Wilkinson JM, Lewis J, Lawrence GP, Lucraft HH, Murphy E
Publication type: Article
Publication status: Published
Journal: British Institute of Radiology
Year: 2007
Volume: 80
Issue: 951
Pages: 209-215
ISSN (print): 0007-1285
ISSN (electronic): 1748-880X
Publisher: British Institute of Radiology
URL: http://dx.doi.org/10.1259/bjr/61306844
DOI: 10.1259/bjr/61306844
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