Dosimetric improvement and examination of multiple brain metastases in cyberknife radiosurgery system

The reasoning behind the stereotactic radiosurgery is the application of high radiation dose from different areas, while maintaining maximum conformity in the target area and maximum protection of critical tissues. Briefly, to create a surgical effect with radiation on a specified target. CyberKnife treatment system, which can apply radiation dose from many different points due to its robotic working principle, is a system related to stereotactic radiosurgery. Isocentric treatments can be performed in Cyberknife and can be performed in non-isocentric treatments. Since the number of bundles is too high as these treatments can increase to much higher doses than conventional treatment doses; The target tissue consists of high dose gradients. At this point, it is of utmost importance to carry out quality checks of patient treatment plans. In the system of sterotactic radiosurgery, the maximum dose is provided in the target with a non-isosynthetic optimization method, while maximum protection of the critical tissues is ensured. Briefly, to create a surgical effect with radiation on a specified target. CyberKnife treatment system, which can apply the radiation dose from many different points due to its robotic operation principle, is a system that can perform stereotactic radiosurgery. In other words, a target (stereotactic) is treated with radiation (radiosurgery). In this treatment, very high doses are given compared to conventional therapies. Due to the nature of the system, the dose gradients are also very high. Recently, instead of irradiation of the whole brain in brain metastases, radiosurgery is performed for all metastases. Brain metastases can be irradiated up to 15 metastases with different studies. In this way, neurocognitive functions are preserved and less brain tissue is irradiated. In this study, the treatment plans of 20 patients with brain metastasis of 3 and above were performed in a single plan and each plan separately. The plans were compared with the single plan and the treatment duration of the plans made separately, the gradient index, the conformity index and the V10 and V12 doses of the whole brain. The plans made separately seem very advantageous in terms of CI, V10 and V12 doses. The only thing that we can specify as an advantage is the duration of treatment.