Brain metastases are the most common intracranial malignancy. Incidence of brain metastases has risen as systemic therapies have improved and patients with metastatic disease live longer. Stereotactic radiosurgery (SRS) has become an increasingly popular option because of its relatively short, convenient, and noninvasive treatment course.
Higher requirements for Patient Immobilization are put forward due to high single irradiation dose and error-tolerant rate of stereotactic radiotherapy/radiosurgery of the head. Relevant guidelines show that the inter-fractional setup error and intra-fractional stability are required to be ≤1mm, so it is generally necessary to use a specially designed SRS Patient Immobilization Solution.
The following cases are from the Fifth Affiliated Hospital of Guangzhou Medical University, Klarity's frameless SRS solution well used for linac-based stereotactic surgery.
The inter-fractional setup errors of 12 patients with intracranial tumors were collected and analyzed on the Varian Trilogy™ System in 35 treatments. It was found that the errors in three directions were as follows: VRT direction (0.01±0.07) cm, LNG direction (0.02±0.09) cm, LAT direction (-0.01±0.07) cm; and the rotation setup error ROT was (-0.05±0.22).
Operation tips for Klarity SRS System
Klarity SRS Masks are made of a new, innovative thermoplastic material that features additional strength and conformability. There is a hollow design of head mask,when moulding a lower mask, it should fit around the patient's neck and head as much as possible to reduce vacancy. After its initial formation, the upper head mask should be made continuously. It should be noted that the patient's ears should not be caught by the frame. After the softened upper radiotherapy mask is buckled and fixed, the heated bitelok should be quickly inserted in the patient's mouth and the dental impression is bitten. Finally, the lower edge is folded to strengthen the chin fixation.
It is suggested that after the upper and lower radiotherapy masks are cooled and hardened for 10 minutes, the green foam headrest should be removed and then perform CT scan to reduce the attenuation of the headrest to rays.
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