{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:49:24Z","timestamp":1777891764723,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["XST"],"published-print":{"date-parts":[[2022,11,24]]},"abstract":"<jats:p>BACKGROUND: Multi Fractionated stereotactic radiosurgery (MF-SRS) of Linac has an essential role in the treatment of skull base meningiomas (sbMNG). However, Gamma Knife Icon (GK) allows MF-SRS using mask immobilization with onboard image guidance. OBJECTIVE: This dosimetric study aims to investigate whether equivalent plan quality can be achieved with Volumetric Modulated Arc Therapy (VMAT) in patients with large sbMNG (&gt;10 cm3) previously treated with GK. METHODS: Twenty patients with the median target volume of 19.7cm3 are re-planned by using VMAT with 20\u200aGy in 5 fractions. Plan qualities are compared to tumor coverage, paddick conformity index (PCI), gradient index (GI), V4\u200aGy, V10\u200aGy, V12\u200aGy, optic chiasm V20\u200aGy, brainstem V23\u200aGy, optic nerve V25\u200aGy volumes, and maximum doses for all. Additionally, beam-on time and approximate planning time are also analyzed and compared. RESULTS: All plans provide adequate clinical requirements. First, the CI is comparable for the GK and VMAT (0.99\u00b10.01 vs. 1.13\u00b10.20; p\u200a=\u200a0.18). Second, VMAT has a significantly higher GI than GK (3.81\u00b10.35 vs. 2.63\u00b10.09; p\u200a&lt;\u200a0.001). Third, the PCI is significantly higher in GK than VMAT (0.76\u00b10.05 vs. 0.70\u00b10.07; p\u200a&lt;\u200a0.001). The lower GI of the GK also results in significantly lower V4\u200aGy (156.1\u00b143.8 vs. 207.5\u00b140.1 cm3, p\u200a&lt;\u200a0.001) and V10\u200aGy (26.1\u00b19.0 vs. 28.9\u00b17.7 cm3, p\u200a&lt;\u200a0.001) compared to VMAT. Last, the VMAT reduces beam-on time (4.8\u00b10.5 vs. 19\u00b11.1\u200amin.; p\u200a&lt;\u200a0.001). CONCLUSION: Although both systems have succeeded in creating effective plans in clinical practice, the GK reveals more effective lower normal brain tissue doses. However, the shorter treatment time with LINAC, excluding the total procedure time, can be considered advantageous over GK.<\/jats:p>","DOI":"10.3233\/xst-221264","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T13:03:43Z","timestamp":1664543023000},"page":"1201-1211","source":"Crossref","is-referenced-by-count":2,"title":["Dosimetric comparison of volumetric modulated arc therapy with TrueBeam LINAC and hypofractionated radiosurgery with gamma knife ICON for large (&gt;10\u200acm3) skull base meningiomas"],"prefix":"10.1177","volume":"30","author":[{"given":"Yucel","family":"Saglam","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Koc University, School of Medicine, Davutpasa Caddesi, Topkapi, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yavuz","family":"Samanci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University, School of Medicine, Davutpasa Caddesi, Topkapi, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasemin","family":"Bolukbasi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Koc University, School of Medicine, Davutpasa Caddesi, Topkapi, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selcuk","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University, School of Medicine, Davutpasa Caddesi, Topkapi, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"issue":"Suppl 5","key":"10.3233\/XST-221264_ref1","doi-asserted-by":"crossref","first-page":"v1","DOI":"10.1093\/neuonc\/noz150","article-title":"CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012\u20132016","volume":"21","author":"Ostrom","year":"2019","journal-title":"Neuro Oncol"},{"issue":"3","key":"10.3233\/XST-221264_ref2","doi-asserted-by":"crossref","first-page":"574","DOI":"10.3171\/2011.11.JNS11999","article-title":"Slower growth of skull base meningiomas compared with non-skull base meningiomas based on volumetric and biological studies","volume":"116","author":"Hashimoto","year":"2012","journal-title":"J Neurosurg"},{"issue":"9","key":"10.3233\/XST-221264_ref3","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S1470-2045(16)30321-7","article-title":"EANO guidelines for the diagnosis and treatment of meningiomas. e","volume":"17","author":"Goldbrunner","year":"2016","journal-title":"Lancet Oncol"},{"issue":"2","key":"10.3233\/XST-221264_ref4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.radonc.2012.07.008","article-title":"Skull base meningiomas: Long-term results and patient self-reported outcome in 507 patients treated with fractionated stereotactic radiotherapy (FSRT) or intensity modulated radiotherapy (IMRT)","volume":"106","author":"Combs","year":"2013","journal-title":"Radiother Oncol"},{"issue":"2","key":"10.3233\/XST-221264_ref5","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1002\/mp.12052","article-title":"Commissioning of the Leksell Gamma Knife((R)) Icon","volume":"44","author":"Zeverino","year":"2017","journal-title":"Med Phys"},{"issue":"4","key":"10.3233\/XST-221264_ref6","first-page":"277","article-title":"Intracranial motion during frameless Gamma-Knife stereotactic radiosurgery","volume":"6","author":"Seneviratne","year":"2020","journal-title":"J Radiosurg SBRT"},{"issue":"4","key":"10.3233\/XST-221264_ref7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1227\/NEU.0000000000000448","article-title":"Comparison of plan quality and delivery time between volumetric arc therapy (RapidArc) and Gamma Knife radiosurgery for multiple cranial metastases. 409-417; 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