BJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kiltie, A. E.
Right arrow Articles by Taylor, R. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kiltie, A. E.
Right arrow Articles by Taylor, R. E.

The British Journal of Radiology, Vol 73, Issue 870 650-654, Copyright © 2000 by British Institute of Radiology

ARTICLES

The need for the moving junction in craniospinal irradiation

AE Kiltie, JM Povall and RE Taylor
Department of Clinical Oncology, Cookridge Hospital, Leeds, UK.

The moving junction is used in craniospinal irradiation (CSI) to smooth out any dose inhomogeneity across the head/spine junction. The aim of this study was to demonstrate the extent of the head/spine junction inhomogeneity in treatment plans of actual patients and to compare stationary and moving junction data. The radiotherapy plans, prescriptions and case notes of 18 patients (12 medulloblastomas, 3 supratentorial primitive neuroectodermal tumours, 2 pineoblastomas and 1 pineal germinoma) treated with CSI (35 Gy in 21 fractions over 29 days) were examined. At 16 months median follow-up (range 1.5-35.5 months), no junctional recurrences or myelopathy were observed. Using the moving junction technique the mean maximum anterior cord dose, from 5 cm caudal to 3 cm cephalad of the Day 1 junction, was 36.3 Gy, and the mean minimum anterior cord dose was 32.9 Gy, with a mean within-patient variation of 3.4 Gy (9.7% of 35 Gy). In four patients, comparison of dose variation across the field junction was made between the original plans and a re-plan using a stationary junction. The effect of a matched junction, a 2 mm overlap and a 2 mm gap were studied both for moving junction and stationary junction techniques. Dose variations were similar in all cases for exactly-matched fields, but for a 2 mm overlap or gap the dose variation was smaller in all but one case for the moving junction technique. These data suggest that the moving junction is important to minimize the risk of overdose or underdose across the spine/head junction in CSI.




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
BJR DMFR IMAGING  ALL BIR JOURNALS 
Copyright © 2000 by the British Institute of Radiology.