Multi-institutional radiotherapy planning study compared Leksell Gamma Knife Perfexion with three advanced linear-accelerator based stereotactic radiosurgery systems
NEW YORK /PRNewswire/ - Persons who need radiotherapy for treatment of multiple brain metastases stand to receive as much as a 74 percent lower radiation dose to normal brain tissue if the lesions are treated with Elekta's Leksell Gamma Knife® Perfexion™ radiosurgery system versus contemporary linear-accelerator-based stereotactic radiosurgery (SRS) systems. These results came from a study1 co-authored by University of California San Francisco physicist Lijun Ma, PhD, and are significant, given the higher likelihood of neurocognitive deficits associated with greater radiation exposure of normal brain tissue.
Dr. Ma's presentation, based on the treatment planning study recently published online in the International Journal of Computer Assisted Radiology and Surgery, was given at the 17th International Leksell Gamma Knife Society Meeting (May 11-15, New York City).
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A follow-up of a previous study2, the latest research: "Variable dose interplay effects across radiosurgical apparatus in treating multiple brain metastases" evaluated peripheral normal brain tissue doses in four systems: Leksell Gamma Knife Perfexion, CyberKnife® (Accuray), Novalis® (Brainlab) linear accelerator with a 3.0 mm multileaf collimator (MLC) and - new for this study - TrueBeam™ (Varian) flattening filter-free linear accelerator with a 2.5 mm MLC. The systems were located at five US and Canadian medical centers that participated in the study.
A multiple (12) metastases SRS case was chosen for independent treatment planning using the delivery systems. Subsets of target combinations with 3, 6, 9 and 12 targets were selected for treatment planning using individual SRS modalities located in different centers, which were selected based on their expertise with the given technology.
"Comparing the volumes of normal brain receiving a radiation dose of 12 Gy, once again - as in the earlier study - the Perfexion system gave the lowest dose to normal brain tissue," Dr. Ma observes. "The 12 Gy volume, which is a known predictor for symptomatic radionecrosis that could lead to adverse neurocognitive effects, was 180 to 290 percent higher for the TrueBeam, Novalis and CyberKnife treatment plans."
Furthermore, for every target number and isodose volume (4, 8, 16, 20 Gy) Perfexion outperformed the other three modalities and, overall, had the highest dose conformity.
