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Field-In-Field Technique With Intrafractionally Modulated Junction Shifts for Craniospinal Irradiation

  • Sue S. Yom
  • , Erik K. Frija
  • , Anita Mahajan
  • , Eric Chang
  • , Kelli Klein
  • , Almon Shiu
  • , Jared Ohrt
  • , Shiao Woo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To plan craniospinal irradiation with "field-in-field" (FIF) homogenization in combination with daily, intrafractional modulation of the field junctions, to minimize the possibility of spinal cord overdose. Methods and Materials: Lateral cranial fields and posterior spinal fields were planned using a forward-planned, step-and-shoot FIF technique. Field junctions were automatically modulated and custom-weighted for maximal homogeneity within each treatment fraction. Dose-volume histogram analyses and film dosimetry were used to assess results. Results: Plan inhomogeneity improved with FIF. Planning with daily modulated junction shifts provided consistent dose delivery during each fraction of treatment across the junctions. Modulation minimized the impact of a 5-mm setup error at the junction. Film dosimetry confirmed that no point in the junction exceeded the anticipated dose. Conclusions: Field-in-field planning and modulated junction shifts improve the homogeneity and consistency of daily dose delivery, simplify treatment, and reduce the impact of setup errors.

Original languageEnglish (US)
Pages (from-to)1193-1198
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume69
Issue number4
DOIs
StatePublished - Nov 15 2007

Keywords

  • Craniospinal irradiation planning
  • Field-in-field technique
  • Junction shift

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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