Comparative Evaluation of Four Stereotactic Radiosurgery Planning Approaches for Treatment of Posterior…

StudyJournal of medical radiation sciences· Mar 2026

Comparative Evaluation of Four Stereotactic Radiosurgery Planning Approaches for Treatment of Posterior Choroidal Melanoma.

Robert Nigro, Kenton Thompson, Cathy Markham … Claire Phillips

Ocular OncologyStudyQ3IF 1.7

Modulated arc techniques cut brain volume receiving 10 Gy to zero versus dynamic conformal arc therapy.

Comparative Evaluation of Four Stereotactic Radiosurgery Planning Approaches for Treatment of Posterior Choroidal Melanoma.

Robert Nigro … Claire Phillips

Journal of medical radiation sciences · Mar 2026

Background

This was a comparative treatment planning study for posterior choroidal melanoma (choroidal melanoma) using four stereotactic approaches: Brainlab iPlan dynamic conformal arc therapy (dynamic conformal arc therapy), Brainlab Elements modulated arcs (BE), Varian Eclipse HyperArc modulated arcs (HA) and Gamma Knife ICON Leksell GammaPlan (GK).

Methods

Thirteen choroidal melanoma cases over 3 years (2015-2018) treated with dynamic conformal arc therapy prescribed 50 Gy in 5 fractions were selected.

Results

less brain tissue got a meaningful radiation dose - none did with the newer techniques

DCAT

0.93cc

GK

0cc

BE

0cc

HA

0cc

More results

Brain D near-max GK 5.52 Gy, HA 6.41 Gy, BE 7.28 Gy, dynamic conformal arc therapy 13.73 Gy (p = 0.001).

The median Gradient Index (Gradient Index) was GK 2.79, dynamic conformal arc therapy 6.39, BE 5.07, HA 6.00 (p < 0.001) with GK significantly different from each of the other approaches for PTV parameters.

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Conclusion · 1 of 2

Modulation tools in HA and BE enabled clinically meaningful reduction in dose to brain compared with dynamic conformal arc therapy whilst maintaining dose to PTV.

Conclusion · 2 of 2

GK produced highest PTV coverage with superior gradient index, however current methods for eye immobilisation and treatment delivery only allow for single fraction treatment with GK.

Comparative Evaluation of Four Stereotactic Radiosurgery Planning Approaches for Treatment of Posterior Choroidal Melanoma.

Comparative Evaluation of Four Stereotactic Radiosurgery Planning Approaches for Treatment of Posterior Choroidal Melanoma.

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