For organs at risk (OARs), both techniques meet their respective planning objectives however IMRT consistently spared the OAR, anterior to the target, more effectively. It could be observed from the results of the homogeneity index that CyberKnife® varied from 1.24 to 1.64 with a mean of 1.40 as compared to that of IMRT, which varied from 1.13 to 1.31 with a mean of 1.27. CyberKnife® appears to have a slight advantage over IMRT in dose conformity, however, the prescription isodose line is lower in cases planned with CyberKnife®. The NCI ranged from 1.25 to 4.88 with a mean of 2.08 and from 1.34 to 5.26 with a mean of 2.23. Results: For the target volume, coverage varied from 0.85 to 1.0 with mean of 0.94 for CyberKnife® and from 0.90 to 1.0 with mean of 0.97 for IMRT. In addition, the homogeneity index, the new conformity index (NCI), and dose distributions in axial, sagittal, and coronal planes were also used to compare treatment plans. Dose-volume histograms were generated for both CyberKnife® and theoretical linac treatment. The prescription dose was normalized to 100% of the maximum dose of each plan. The fractional size for each treatment course ranged from 1 to 5 fractions and dose per fraction ranged from 500 to 1,600 cGy. The median volume of 7 lesions was 14.66 (range 0.24–64.11) cm3. Anderson Cancer Center for the purposes of creating a theoretical IMRT treatment plan for the linac. Seven CT-image sets from SCC including the contours, and dose-matrix were imported through DICOM-RT into the Pinnacle3® treatment-planning system at M.D. Methods: The study includes patients with metastatic disease who have undergone CyberKnife® treatment at the Seattle CyberKnife® Center (SCC) since February 2006. CyberKnife® radiosurgery and intensity-modulated radiotherapy (IMRT) are assessed using comparative treatment methods on patients with spinal and lung metastases. Aims: This study evaluates potential benefits and limitations of two different radiation delivery systems.
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