The Physician Tendency in Stereotactic Radiosurgery Dose Prescription in Benign Intracranial Tumor at dr. Cipto Mangunkusumo National Hospital, Jakarta

• Main Authors: Henry Kodrat, Soehartati Gondhowiardjo, Renindra Ananda Aman
• Format: Article
• Language: English
• Published: Universitas Indonesia 2016-09-01
• Series: Journal Kedokteran Indonesia
• Subjects: stereotactic; radiosurgery; benign tumor; dose.
• Online Access: http://journal.ui.ac.id/index.php/eJKI/article/view/6282

<!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG /> </o:OfficeDocumentSettings> </xml><![endif]--> <p class="MsoNoSpacing" style="text-align: justify;">Stereotactic radiosurgery (SRS) is one of the treatment modalities for benign intra-cranial tumor, especiallyfor the tumor located next to the critical neural structure. The prescribed dose for radiosurgery depends onthe maximal tumor diameter and surrounding normal tissue tolerance dose. This cross sectional study wasconducted to evaluate the physician&rsquo;s tendency in radiosurgery dose prescription. We observed treatmentplanning data of 32 patients with benign intra-cranial tumor, which had been treated with SRS at Dr. CiptoMangunkusumo National Hospital in 2009-2010. The peripheral dose, organ at risk (OAR) dose limitiationand maximum tumor diameter were recorded. We compared our SRS dose with dose limitation, whichallowed safer dosing based on maximal tumor diameter perspective and the nearest OAR dose constraint.From maximal tumor diameter perspective, we prescribed mean&plusmn;SD radiosurgery doses, which were11.63&plusmn;2.21Gy, 10.21&plusmn;1.29Gy and 9.88&plusmn;1.07Gy for the tumor size &le;2cm, 2.01-3cm and 3,01-4cm respectively.Our radiosurgery dose was the lowest than dose limitation based on the nearest OAR perspective, followedby maximal tumor diameter perspective. It was concluded that radiosurgery dose had the tendency to beinfluenced by surrounding healthy tissue tolerance rather than maximal tumor diameter.</p> <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves /> <w:TrackFormatting /> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF /> <w:LidThemeOther>IN</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> <w:SplitPgBreakAndParaMark /> <w:EnableOpenTypeKerning /> <w:DontFlipMirrorIndents /> <w:OverrideTableStyleHps /> </w:Compatibility> <m:mathPr> <m:mathFont m:val="Cambria Math" /> <m:brkBin m:val="before" /> 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Accent 5" /> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5" /> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5" /> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5" /> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5" /> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5" /> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6" /> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 6" /> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6" /> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6" /> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6" /> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6" /> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6" /> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6" /> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6" /> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6" /> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6" /> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6" /> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6" /> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6" /> <w:LsdException Locked="false" Priority="19" QFormat="true" Name="Subtle Emphasis" /> <w:LsdException Locked="false" Priority="21" QFormat="true" Name="Intense Emphasis" /> <w:LsdException Locked="false" Priority="31" QFormat="true" Name="Subtle Reference" /> <w:LsdException Locked="false" Priority="32" QFormat="true" Name="Intense Reference" /> <w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title" /> <w:LsdException Locked="false" Priority="37" SemiHidden="true" UnhideWhenUsed="true" Name="Bibliography" /> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="TOC Heading" /> <w:LsdException Locked="false" Priority="41" Name="Plain Table 1" /> <w:LsdException Locked="false" Priority="42" Name="Plain Table 2" /> <w:LsdException Locked="false" Priority="43" Name="Plain Table 3" /> <w:LsdException Locked="false" Priority="44" Name="Plain Table 4" /> <w:LsdException Locked="false" Priority="45" Name="Plain Table 5" /> <w:LsdException Locked="false" Priority="40" Name="Grid Table Light" /> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light" /> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2" /> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3" /> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4" /> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark" /> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful" /> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful" /> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 1" /> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1" /> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1" /> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1" /> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1" /> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 1" /> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 1" /> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 2" /> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2" /> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2" /> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2" /> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2" /> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 2" /> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 2" /> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 3" /> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3" /> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3" /> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3" /> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3" /> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 3" /> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 3" /> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 4" /> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4" /> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4" /> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4" /> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4" /> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful A