International Journal of Hematology and Oncology 2019, Vol 29, Num 3 Page(s): 036-041
Analysis of Three-Dimensional Radiotherapy Treatment Plans in Palliative Spinal Bone Irradiation

Fundagül ANDİÇ1, Mustafa ADLI1, Ahmet DİRİER1, E. Burçin İSPİR1, Pınar A. ÖZTÜRK1

Gaziantep Üniversitesi, Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, GAZİANTEP

Keywords: Palliative radiotherapy, 3D radiotherapy, Spinal bone irradiation
The study aimed to analyze dosimetric data of patients received palliative spinal bone irradiation using three-dimensional (3D) treatment planning with respect to International Commission on Radiation Units and Measurements (ICRU) Report 50 recommendations. 3D treatment plans of 53 patients treated for spinal bone metastasis were included in the study. Sixty treatment plans approved by three physicians were analyzed. The spinal cord, esophagus and intestines were contoured prospectively if located in the treatment fields. The mean of minimum, maximum and mean planning target volume (PTV) doses were 91.0 ± 4.6%, 117.7 ± 7.6% and 105.7 ± 3.9%, respectively. When the mean of minimum, maximum and mean PTV doses were compared according to the attending physicians, there was no statistically significant difference. When the treatment plans were compared according to the fields used, mean of minimum PTV doses were significantly lower and mean of maximum PTV doses were significantly higher in the singleposterior field plans than in the two-opposed field plans (p< 0.001). The mean doses to the spinal cord were lower in the two-opposed field plans than in the single-posterior field plans (p< 0.001). The mean doses of esophagus and intestines were higher (p< 0.001) in two-opposed field plans than in single-posterior field plans, however, less than the prescribed dose. Treatment plans of palliative spinal bone irradiation approved by three physicians did not accomplish the ICRU Report 50 recommendations, despite using 3D radiotherapy planning. However, two-opposed field plans resulted in a better dose distribution close to ICRU Report 50 recommendations with tolerable doses to the spinal cord, esophagus and intestines.