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World J Clin Cases. Dec 16, 2022; 10(35): 12822-12836
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12822
Planning issues on linac-based stereotactic radiotherapy
Yang-Yang Huang, Jun Yang, Yi-Bao Liu
Yang-Yang Huang, Yi-Bao Liu, School of Nuclear Science and Engineering, East China University of Technology, Nanchang 330013, Jiangxi Province, China
Yang-Yang Huang, Department of Radiotherapy, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
Jun Yang, Department of Radiotherapy, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Huang YY contributed to the majority of the writing; Yang J performed the Table; and Liu YB edited the article.
Supported by the National Natural Science Foundation of China, No. 11965001; and Henan Province Medical Science and Technology Project, No. LHGJ20210407.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Bao Liu, PhD, Chairman, School of Nuclear Science and Engineering, East China University of Technology, No. 418 Guanglan Avenue, Economic Development Zone, Nanchang 330013, Jiangxi Province, China. lyb01@tsinghua.org.cn
Received: September 30, 2022
Peer-review started: September 30, 2022
First decision: October 13, 2022
Revised: October 20, 2022
Accepted: November 14, 2022
Article in press: November 14, 2022
Published online: December 16, 2022
Processing time: 74 Days and 22.8 Hours
Abstract

This work aims to summarize and evaluate the current planning progress based on the linear accelerator in stereotactic radiotherapy (SRT). The specific techniques include 3-dimensional conformal radiotherapy, dynamic conformal arc therapy, intensity-modulated radiotherapy, and volumetric-modulated arc therapy (VMAT). They are all designed to deliver higher doses to the target volume while reducing damage to normal tissues; among them, VMAT shows better prospects for application. This paper reviews and summarizes several issues on the planning of SRT to provide a reference for clinical application.

Keywords: Stereotactic radiotherapy; Treatment technology; Energy; Isocenters; Coplanar/noncoplanar fields; Calculation algorithm; Multileaf collimator leaf width; Flattening filter free mode; Small field dosimetry; Grid size

Core Tip: In recent years, stereotactic radiotherapy (SRT) has been moving towards large-scale applications with radiotherapy device hardware and software development. SRT has the advantages of a high single dose (6-30 Gy/fraction), low treatment frequency (1-5 fraction), a high biological effect dose ≥ 100, high target volume conformity index, and a hefty dose gradient index outside the target volume. This paper analyzes the SRT planning issues such as the treatment technology, energy, number of isocenters, number of fields, coplanar/noncoplanar issue, the dose calculation algorithm of treatment planning system, multileaf collimator leaf width, flattening filter free mode, auxiliary contours such as ring/shell, small field dosimetry, grid size and auto planning.