Exploring stereotactic radiosurgery for tremor using the Varian cone planning system.

BACKGROUND

Stereotactic radiosurgery (SRS) is an effective treatment for essential tremor (ET) and Parkinsonian tremor (PT). However, current treatment methods can be time-consuming and expose patients to unnecessary radiation. This study investigates the use of the Varian TrueBeam system with FFF beam modes as a potential solution for these issues.

METHODS

We recreated and evaluated treatment plans using the Varian TrueBeam and Eclipse Cone Planning system for ten patients previously treated for tremor cessation using a Novalis Tx linear accelerator with Brainlab planning system prescribed a maximum dose of 160 Gy. Analyses included beam-on delivery time, total MU, dose to brain and brainstem tissues, and confirmation of SRS cone accuracy.

RESULTS

The TrueBeam cone delivery system is highly accurate. Our results demonstrated a significant reduction in monitor units (MU) and treatment delivery time shortened to 17-26 min beam-on time for all-Varian plans compared to 39 min for non-Varian (iPlan) plans (p < 0.0001). Furthermore, the Varian plans showed improved or similar dose fall-off and radiation dose to brainstem normal tissue.

CONCLUSION

Our findings suggest that the Varian TrueBeam system offers a safe and effective option for SRS tremor treatment, providing similar or superior treatment parameters compared to other LINAC-based SRS treatments. The reduced treatment times and improved patient comfort offered by this system make it a promising solution for future tremor treatments.