Document Detail

Commissioning and clinical results utilizing the Gildenberg-Laitinen Adapter Device for X-ray in fractionated stereotactic radiotherapy.
MedLine Citation:
PMID:  12738337     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Gildenberg-Laitinen Adapter Device for X-Ray (GLAD-X/LS) frame is a positioning device that allows the use of the same fiducial points as the Brown-Robert-Wells (BRW) system. Thus it permits treatment planning to be accomplished by the Radionics X-knife Radiosurgery Program. We investigated the commissioning and clinical benefits of the GLAD-X/LS for fractionated stereotactic radiotherapy (FSRT) in patients who were unable to tolerate the Gill-Thomas-Cosman (GTC) frame. METHODS AND MATERIALS: Commissioning of the GLAD-X/LS system was done via use of a Rando Phantom. A target volume of 2 x 2 x 2 cm was drilled into the phantom head. An ion chamber and thermoluminescence dosimetric chips (TLDs) were implanted in the target. A simulated treatment course consisting of 5 stereotactic radiotherapy fractions (300 cGy, 30 mm collimator) was delivered to the phantom head. A total of 27 patients who could not tolerate the GTC frame were treated using the GLAD-X/LS system. A total of 35 isocenters were used; the median number of treatment fractions was eight. Reproducibility of the x, y, and z coordinates was examined and correlated to the same determined using orthogonal port films. Relocation accuracy and reproducibility were further assessed comparing the x, y, and z coordinates of the target center with multiplanar reconstructed coronal and sagittal images. Patient tolerance of the device was also evaluated daily throughout the treatment. RESULTS: The measured TLD and ion chamber doses were within 3% of the prescribed dose at the isocenter. The same dose accuracy was also found at incremental distances of 5 mm, 10 mm, and 15 mm from the isocenter. All patients tolerated the treatment and the device well. Six patients experienced mild ear canal pain, and softer or smaller earpieces were substituted. The mean relocation accuracy was 1.5 mm +/- 0.8. CONCLUSIONS: The GLAD-X/LS system has excellent accuracy and reproducibility with the mean relocation accuracy of 1.5 mm +/- 0.8. The device is well-tolerated by patients, with no significant complications. Larger scale studies are necessary before routine use can be recommended for the administration of FSRT.
H Ashamalla; D Addeo; N C Ikoro; P Ross; M Cosma; N Nasr
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  56     ISSN:  0360-3016     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-05-09     Completed Date:  2003-06-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-8     Citation Subset:  IM    
Department of Radiation Oncology, New York Methodist Hospital, Weill Medical College-Cornell University, New York, NY, USA.
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MeSH Terms
Brain Neoplasms / radiography,  surgery*
Dose Fractionation
Equipment Design
Glioma / radiography,  surgery
Meningioma / radiography,  surgery
Phantoms, Imaging*
Radiosurgery / instrumentation*
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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