A Dosimetric Parameter Reference Look-Up Table for GRID Collimator-Based Spatially Fractionated Radiation Therapy

Simple Summary Dose prescription for the inhomogeneous dosing in spatially fractionated radiation therapy (SFRT) is challenging, and further hampered by the inability of several planning systems to incorporate complex SFRT dose patterns. We developed dosing reference tables for an inventory of tumour scenarios and tested their accuracy with water phantom measurements of GRID therapy, delivered by a standard commercial GRID collimator. We find that dose heterogeneity parameters and EUD modeling are consistent across tumour sizes, configurations, and treatment depths. These results suggest that the developed reference tables can be used as a practical clinical resource for clinical decision-making on GRID therapy and to facilitate heterogeneity dose estimates in clinical patients when this commercially available GRID device is used. Computations of heterogeneity dose parameters in GRID therapy remain challenging in many treatment planning systems (TPS). To address this difficulty, we developed reference dose tables for a standard GRID collimator and validate their accuracy. The .decimal Inc. GRID collimator was implemented within the Eclipse TPS. The accuracy of the dose calculation was confirmed in the commissioning process. Representative sets of simulated ellipsoidal tumours ranging from 6-20 cm in diameter at a 3-cm depth; 16-cm ellipsoidal tumours at 3, 6, and 10 cm in depth were studied. All were treated with 6MV photons to a 20 Gy prescription dose at the tumour center. From these, the GRID therapy dosimetric parameters (previously recommended by the Radiosurgery Society white paper) were derived. Differences in D5 through D95 and EUD between different tumour sizes at the same depth were within 5% of the prescription dose. PVDR from profile measurements at the tumour center differed from D10/D90, but D10/D90 variations for the same tumour depths were within 11%. Three approximation equations were developed for calculating EUDs of different prescription doses for three radiosensitivity levels for 3-cm deep tumours. Dosimetric parameters were consistent and predictable across tumour sizes and depths. Our study results support the use of the developed tables as a reference tool for GRID therapy.