The implication of non-cyclic intrafractional longitudinal motion in SBRT by TomoTherapy

Phys Med Biol. 2009 May 7;54(9):2875-84. doi: 10.1088/0031-9155/54/9/019. Epub 2009 Apr 21.

Abstract

To determine the dosimetric impact of non-cyclic longitudinal intrafractional motion, TomoTherapy plans with different field sizes were interrupted during a phantom delivery, and a displacement between -5 mm and 5 mm was induced prior to the delivery of the completion procedure. The planar dose was measured by film and a cylindrical phantom, and under-dosed or over-dosed volume was observed for either positive or negative displacement. For a 2.5 cm field, there was a 4% deviation for every mm of motion and for a 1 cm field, the deviation was 8% per mm. The dimension of the under/over-dosed area was independent of the motion but dependent on the field size. The results have significant implication in small-field high-dose treatments (i.e. stereotactic body radiation therapy (SBRT)) that deliver doses in only a few fractions. Our studies demonstrate that a small longitudinal motion may cause a dose error that is difficult to compensate; however, dividing a SBRT fraction into smaller passes is helpful to reduce such adverse effects.

MeSH terms

  • Dose Fractionation, Radiation*
  • Humans
  • Movement*
  • Phantoms, Imaging
  • Radiometry
  • Radiosurgery / mortality*