Comparison between the HyperArc™ technique and the CyberKnife® technique for stereotactic treatment of brain metastases

Guinement, L.; Salleron, Julia; Buchheit, I.; Gérard, K.; Faivre, Jean; Royer, P.; Marchesi, V.

doi:10.1016/j.canrad.2022.08.007

Cited by 4 publications

(5 citation statements)

References 46 publications

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“…Statistical results indicated no significant differences, and Figure 8 classifies the CI, GI, V 4Gy , and V 12Gy for CK (orange points) and HA (green points), demonstrating random distribution across the groups, a finding consistent with Guinement's research. 24 Regarding target doses, CK plans achieved higher doses in the planning target volume (PTV), corroborating the findings of Kadoya and Slosarek, where CK plans exhibited higher D max , D min , D mean , and HI in the PTV. 21,22 This is likely due to the use of only predefined segments in the sequential optimization process, which failed to adequately control the inner dose region, thus delivering higher doses to the target.…”

Section: Discussionsupporting

confidence: 83%

“…Additionally, a point biserial analysis was conducted to discern dosimetric differences between single and multiple lesion cases. Statistical results indicated no significant differences, and Figure 8 classifies the CI, GI, V 4Gy , and V 12Gy for CK (orange points) and HA (green points), demonstrating random distribution across the groups, a finding consistent with Guinement's research 24 …”

Section: Discussionsupporting

confidence: 83%

“…18,19,20 Previous studies comparing HA and CK, as well as other techniques, for single and multiple brain metastases revealed that HA plans significantly reduce treatment time and are comparable with CK plans in sparing normal brain tissue, especially in larger and more complex cases. 21,22,23,24 However, these studies optimized CK plans with circular collimators. Given the differences in target shaping between cones and MLC, a comparison between two MLC-based techniques might be more appropriate.…”

Section: Introductionmentioning

confidence: 99%

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Dosimetric comparison of HyperArc and InCise MLC‐based CyberKnife plans in treating single and multiple brain metastases

Zhu,

Dong,

Sun

et al. 2024

J Applied Clin Med Phys

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Background and PurposeThis study aimed to compare the dosimetric attributes of two multi‐leaf collimator based techniques, HyperArc and Incise CyberKnife, in the treatment of brain metastases.Material and Methods17 cases of brain metastases were selected including 6 patients of single lesion and 11 patients of multiple lesions. Treatment plans of HyperArc and CyberKnife were designed in Eclipse 15.5 and Precision 1.0, respectively, and transferred to Velocity 3.2 for comparison.ResultsHyperArc plans provided superior Conformity Index (0.91 ± 0.06 vs. 0.77 ± 0.07, p < 0.01) with reduced dose distribution in organs at risk (Dmax, p < 0.05) and lower normal tissue exposure (V4Gy–V20Gy, p < 0.05) in contrast to CyberKnife plans, although the Gradient Indexes were similar. CyberKnife plans showed higher Homogeneity Index (1.54 ± 0.17 vs. 1.39 ± 0.09, p < 0.05) and increased D2% and D50% in the target (p < 0.05). Additionally, HyperArc plans had significantly fewer Monitor Units (MUs) and beam‐on time (p < 0.01).ConclusionHyperArc plans demonstrated superior performance compared with MLC‐based CyberKnife plans in terms of conformity and the sparing of critical organs and normal tissues, although no significant difference in GI outcomes was noted. Conversely, CyberKnife plans achieved a higher target dose and HI. The study suggests that HyperArc is more efficient and particularly suitable for treating larger lesions in brain metastases.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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Dosimetric comparison of HyperArc and InCise MLC‐based CyberKnife plans in treating single and multiple brain metastases

Zhu,

Dong,

Sun

et al. 2024

J Applied Clin Med Phys

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“…Total brain V18Gy and V12Gy were 11 and 20.2 cm 3 for HA-VMAT vs 18 and 34.1 cm 3 for CyberKnife ( P < .001). [ 8 ] Recently, HA-VMAT has been used to treat nonbrain lesions. Inui et al [ 3 ] demonstrated that HA-VMAT provided significantly lower mean brain doses than conventional VMAT for the treatment of scalp angiosarcoma (12.63 ± 3.31 Gy vs 17.11 ± 5.25 Gy, P = .005).…”

Section: Discussionmentioning

confidence: 99%

HyperArcTM volumetric modulated arc therapy for hypopharyngeal cancer with solitary recurrence in the cervical vertebra: A case report and literature review

Lin,

Que,

2024

Medicine

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Rationale: It is difficult to reirradiate head and neck cancers because of the toxicity from previous radiation dose delivery. Conventional volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy often have poor target coverage. The new HyperArcTM VMAT (HA-VMAT) planning approach reportedly has better target coverage, higher conformity, and can spare normal organs compared to conventional VMAT; however, research on recurrent head and neck cancers is limited. Here, we report the clinical outcomes of HA-VMAT for previously irradiated hypopharyngeal cancer with solitary recurrence in the first cervical vertebra (C1). Patient concerns: A 52-year-old Asian male was diagnosed with a hypopharyngeal cancer. The patient received concurrent chemoradiotherapy with a radiation dose of 70 Gy in 33 fractions and achieved complete clinical response. Two years later, solitary recurrence was observed in the C1 vertebra. Diagnoses: Solitary recurrence in the C1 vertebra. Interventions: Owing to concerns regarding the toxicity to adjacent organs, we decided to use HA-VMAT to achieve better tumor coverage and critical organ sparing. Outcomes: Tumor regression was observed on the imaging. At 9 months follow-up, the patient was disease-free and had no late toxicities. Lessons: This is the first report regarding the clinical outcomes of HA-VMAT for previously irradiated hypopharyngeal cancer with solitary recurrence over the C1 vertebra. HA-VMAT achieves highly conformal dose distribution and excellent sparing of critical organs. There was a favorable initial clinical response with no toxicity. Long-term follow-up is essential in such cases.

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“…Vergalasova et al (2019) andGuinement et al (2023) all found HyperArc 6 MV FFF produced significantly smaller V12Gy volumes than CyberKnife and Gamma Knife. Vergalasova et al (2019) observed a shift in which modality produced the superior V12Gy depending on tumour volume.…”

mentioning

confidence: 94%

Plan quality assessment of modern radiosurgery technologies in the treatment of multiple brain metastases

Hiscoke,

Leong,

Hogan

et al. 2024

Biomed. Phys. Eng. Express

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Stereotactic radiosurgery (SRS) of multiple brain metastases has evolved over the last 40 years allowing centres to treat an increasing number of brain metastases in a single treatment fraction. HyperArcTM planning optimisation technique is one such development that streamlines the treatment of multiple metastases with a single isocentre. Several studies have investigated the plan quality of HyperArc compared to CyberKnife or Gamma Knife, however there are limited number of studies that include all three modalities. It was the aim of this study to provide an assessment of plan quality between the three SRS platforms across ten patients with multiple brian metastases ranging from three to eight metastases per patient. Strict planning workflows were established to avoid bias towards any particular treatment platform. Plan quality was assessed through dose to organs at risk, Paddick conformity index (PCI), gradient index (GI), global efficiency index (Gη) and dose to normal brain tissue. Results from this study found mean PCI observed across Gamma Knife plans was significantly lower than HyperArc and CyberKnife. HyperArc plans observed significantly shorter beam-on times which were 10 to 20 times faster than CyberKnife and Gamma Knife plans. Gamma Knife and CyberKnife were found to produce plans with significantly superior GI, global efficiency index and the volume of healthy brain receiving greater than 12 Gy (V12Gy) when compared to HyperArc plans. Lesion volume was seen to influence the relative difference in dose metrics between systems. The study revealed that all three treatment modalities produced high quality plans for the SRS treatment of multiple brain metastases, each with respective benefits and limitations.

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Comparison between the HyperArc™ technique and the CyberKnife® technique for stereotactic treatment of brain metastases

Cited by 4 publications

References 46 publications

Dosimetric comparison of HyperArc and InCise MLC‐based CyberKnife plans in treating single and multiple brain metastases

Dosimetric comparison of HyperArc and InCise MLC‐based CyberKnife plans in treating single and multiple brain metastases

HyperArcTM volumetric modulated arc therapy for hypopharyngeal cancer with solitary recurrence in the cervical vertebra: A case report and literature review

Plan quality assessment of modern radiosurgery technologies in the treatment of multiple brain metastases

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