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A dosimetric comparison of linac-based stereotactic fractionated radiotherapy techniques for pituitary adenoma and craniopharyngioma

  • Sunitha S. Varghese (a1), Giriyappa Goudar (a1), Susen Abraham (a1), Timothy Peace (a1), Rabi R. Singh (a1) and Sevamani Backianathan (a1)...



To compare the dosimetric outcomes of linear accelerator-based stereotactic radiotherapy (SRT) techniques—static conformal field (SCF), static conformal arc (SCA) and dynamic conformal arc (DCA), for treating pituitary adenoma and craniopharyngioma.

Materials and methods

Computer image sets of 20 patients with pituitary adenoma or craniopharyngioma and treated with post-operative SRT were selected for this study. For each dataset, three SRT plans, with SCF, SCA and DCA techniques were generated using Brain LAB, iPlan RT V.4.5.3, TPS software. The conformity index (CI), homogeneity index (HI), quality of coverage of the target, dose–volume histograms for the target and organs at risk (OARs) and the time taken to deliver treatment was compared across three sets of plan.


There were 12 patients with pituitary adenoma and eight with craniopharyngioma. The CI and HI were comparable across three techniques. The quality of coverage was superior in DCA technique. OARs were better spared in SCF and DCA techniques. Time taken to deliver treatment was least in SCF technique.


The linac-based SRT techniques SCF, SCA and DCA are efficient in delivering highly conformal and homogenous dose to the target in pituitary adenoma and craniopharyngioma. Among these three techniques, SCF and DCA had acceptable quality of coverage. The dose received by OARs was least in the SCF technique.


Corresponding author

Author for correspondence: Sunitha Susan Varghese, Christian Medical College and Hospital Vellore, Vellore 632004, Tamil Nadu, India. Tel: 91 416 228 3145. E-mail:


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1. Clark, A J, Cage, T A, Aranda, D, Parsa, A T, Auguste, K I, Gupta, N. Treatment-related morbidity and the management of pediatric craniopharyngioma: a systematic review. J Neurosurg Pediatr 2012; 10 (4): 293301.
2. Müller, H L. Consequences of craniopharyngioma surgery in children. J Clin Endocrinol Metab 2011; 96 (7): 19811991.
3. Harrabi, S B, Adeberg, S, Welzel, T et al. Long term results after fractionated stereotactic radiotherapy (FSRT) in patients with craniopharyngioma: maximal tumor control with minimal side effects. Radiat Oncol Lond Engl [Internet] 2014; 9 Accessed on 28th November 2017.
4. Colombo, F, Benedetti, A, Pozza, F et al. Stereotactic radiosurgery utilizing a linear accelerator. Appl Neurophysiol 1985; 48 (1–6): 133145.
5. Lutz, W, Winston, K R, Maleki, N. A system for stereotactic radiosurgery with a linear accelerator. Int J Radiat Oncol Biol Phys 1988; 14 (2): 373381.
6. Bourland, J D, McCollough, K P. Static field conformal stereotactic radiosurgery: physical techniques. Int J Radiat Oncol Biol Phys 1994; 28 (2): 471479.
7. Clark, B G, Robar, J L, Nichol, A M. Analysis of treatment parameters for conformal shaped field stereotactic irradiation: comparison with non-coplanar arcs. Phys Med Biol 2001; 46 (12): 30893103.
8. Perks, J R, Jalali, R, Cosgrove, V P et al. Optimization of stereotactically-guided conformal treatment planning of sellar and parasellar tumors, based on normal brain dose volume histograms. Int J Radiat Oncol Biol Phys 1999; 45 (2): 507513.
9. Gill, S S, Thomas, D G, Warrington, A P, Brada, M. Relocatable frame for stereotactic external beam radiotherapy. Int J Radiat Oncol Biol Phys 1991; 20 (3): 599603.
10. Heilbrun, M P, Roberts, T S, Apuzzo, M L, Wells, T H, Sabshin, J K. Preliminary experience with Brown-Roberts-Wells (BRW) computerized tomography stereotaxic guidance system. J Neurosurg 1983; 59 (2): 217222.
11. Shaw, E, Kline, R, Gillin, M et al. Radiation Therapy Oncology Group: radiosurgery quality assurance guidelines. Int J Radiat Oncol Biol Phys 1993; 27 (5): 12311239.
12. Ammar, H, Eldebawy, E, Maarouf, E, Khalil, W, Zaghloul, M S. Evaluation of the peripheral dose and the conformity index for three stereotactic radiotherapy techniques: arcs, noncoplanar fixed fields and intensity modulation. Int J Cancer Ther Oncol [Internet] 2014; 2 (4) Accessed on 18th August 2017.
13. Sharma, S D, Jalali, R, Phurailatpam, R D, Gupta, T. Does intensity-modulated stereotactic radiotherapy achieve superior target conformity than conventional stereotactic radiotherapy in different intracranial tumours? Clin Oncol R Coll Radiol G B 2009; 21 (5): 408416.
14. Wiggenraad, R G J, Petoukhova, A L, Versluis, L, van Santvoort, J P C. Stereotactic radiotherapy of intracranial tumors: a comparison of intensity-modulated radiotherapy and dynamic conformal arc. Int J Radiat Oncol Biol Phys 2009; 74 (4): 10181026.
15. Cardinale, R M, Benedict, S H, Wu, Q, Zwicker, R D, Gaballa, H E, Mohan, R. A comparison of three stereotactic radiotherapy techniques; ARCS vs. noncoplanar fixed fields vs. intensity modulation. Int J Radiat Oncol Biol Phys 1998; 42 (2): 431436.
16. Hamilton, R J, Kuchnir, F T, Sweeney, P et al. Comparison of static conformal field with multiple noncoplanar arc techniques for stereotactic radiosurgery or stereotactic radiotherapy. Int J Radiat Oncol Biol Phys 1995; 33 (5): 12211228.
17. Solberg, T D, Boedeker, K L, Fogg, R, Selch, M T, DeSalles, A A. Dynamic arc radiosurgery field shaping: a comparison with static field conformal and noncoplanar circular arcs. Int J Radiat Oncol Biol Phys 2001; 49 (5): 14811491.


A dosimetric comparison of linac-based stereotactic fractionated radiotherapy techniques for pituitary adenoma and craniopharyngioma

  • Sunitha S. Varghese (a1), Giriyappa Goudar (a1), Susen Abraham (a1), Timothy Peace (a1), Rabi R. Singh (a1) and Sevamani Backianathan (a1)...


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