A Novel Strategy for Lattice Radiotherapy: Integrating X-Ray and γ-Ray Technologies to Optimize Dose Delivery
Abstract
Purpose
To evaluate the dosimetric advantages of the TaiChi radiotherapy platform—an NMPA‑ and FDA‑approved system combining LINAC and Gamma Knife technologies—for lattice radiotherapy (LRT) , comparing its dose‑escalation capability and normal‑tissue sparing with conventional C‑arm LINAC plans.
Methods
Thirty patients (10 each with lung, liver, and soft‑tissue sarcoma) received combined LRT (15 Gy single‑fraction to spherical vertices within GTV) and conventionally fractionated radiotherapy to PTV. TaiChi employed γ‑ray focusing for vertex dose escalation while optimizing LINAC‑based PTV coverage. Dosimetric comparisons included vertex coverage, dose fall‑off, and OAR sparing.
Results
TaiChi showed superior performance: higher vertex Dmean (18.97 ± 0.48 Gy vs. 16.46 ± 0.95 Gy, p < 0.0001) and D0.5 cc (25.32 ± 0.45 Gy vs. 18.87 ± 0.46 Gy, p < 0.0001), steeper dose gradients (GTV D10/D90: 5.86 ± 0.87 vs. 3.20 ± 0.65, p < 0.0001), and lower margin doses (3.85 ± 0.56 Gy vs. 4.98 ± 0.49 Gy, p < 0.0001), all while maintaining or reducing OAR exposure.
Conclusion
The TaiChi platform’s integrated X‑ray/γ‑ray delivery provides distinct dosimetric benefits for LRT, enabling superior vertex dose escalation with steep gradients and effective normal‑tissue protection, supporting its clinical potential for advanced LRT applications.