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Para-spinal Tumors Encircling the Spinal Cord IMRT. Comparison of Several Target Definitions. SLICE 116 CTV Superior Brain stem and L & R eyes. Slice 104 CTV , Spinal cord L & R Parotid glands. Slice 83 Mid Volume CTV 3 – 5 mm separation between spinal cord and CTV.

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Para spinal tumors encircling the spinal cord imrt
Para-spinal Tumors Encircling the Spinal Cord IMRT

Comparison of Several Target Definitions


SLICE 116

CTVSuperior

Brain stem and L & R eyes


Slice 104

CTV , Spinal cord

L & R Parotid glands


Slice 83 Mid Volume CTV

3 – 5 mm separation between spinal cord and CTV


Slice 63

Inferior CTV

13 mm Separation of spinal cord and CTV


Planning volumes
Planning Volumes

CTV 3mm Expansion 63 Gy

Spinal Cord 3mm Expansion 43 Gy

Rt & Lt Eyes 3mm Expansion 3 Gy

Brain Stem 3mm Expansion 43Gy

Parotid Glands 3mm Expansion 30 Gy



Beam Arrangement

Gantry 0

Gantry 40

Gantry 80

Gantry 160

Gantry 200

Gantry 315



Dose Statistics

63 Gy

Target Type Basic


DVH 63 Gy

Target Type Basic

63 Gy @ ~76% Volume




Dose Statistics

63 Gy

Target Type Homogenous


DVH 63 Gy

Target Type Homogenous

63Gy @ ~46 % Volume




Dose Statistics

63 Gy

Target Type IMRS

Emphasizes Conformality


DVH 63 Gy

Target Type IMRS

63Gy @ ~90% Volume






Intensity Levels 10

Step Increment 1cm

MLC leaf 1cm


Step increment
Step Increment

1cm step with 0.5cm MLC

0.5cm step with 0.5cm MLC

9991-959-08C






Large Complex Treatment Volume

Long (~ 60 cm) volume needed 27 junctioned IMRT fields and

an 16 MeV electron field











12 Mev Beam at 0 Foils0

12 Mev beam at 400






Interoperative Radiation Therapy Foils

The benefit of IORT normal tissues are removed from

the treatment fields and the dose is delivered locally.

The enengy of the electron beams used is usually between

9-16 Mev.

The use in the country has been developed used at large

medical centers.



ORIGINAL HARD DOCKING COX LL Foils

STANDARD LINEAR ACCELERATOR


MGH Foils

SOFT DOCKING

LASER SYSTEM IN

HEAD OF MACHINE



MOBETRON HARD DOCKING Foils

Energies Available

4, 6, 9 & 12 Mev


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