In EDS ansehen

Interfractional variation in whole-breast VMAT irradiation: a dosimetric study with complementary SGRT and CBCT patient setup.

Gespeichert in:
Bibliographische Detailangaben
Titel: Interfractional variation in whole-breast VMAT irradiation: a dosimetric study with complementary SGRT and CBCT patient setup.
Autoren: Mankinen M; Deparment of Physics, University of Jyväskylä (JYU), Survontie 9 C, 40014, Jyväskylä, Finland. mikko.m.mankinen@student.jyu.fi.; Deparment of Medical Physics, Hospital Nova of Central Finland, Wellbeing Services County of Central Finland, Jyväskylä, Finland. mikko.m.mankinen@student.jyu.fi., Virén T; Center of Oncology, Kuopio University Hospital (KUH), The Wellbeing Services Country of North Savo, Kuopio, Finland., Seppälä J; Center of Oncology, Kuopio University Hospital (KUH), The Wellbeing Services Country of North Savo, Kuopio, Finland., Koivumäki T; Deparment of Physics, University of Jyväskylä (JYU), Survontie 9 C, 40014, Jyväskylä, Finland.; Deparment of Medical Physics, Hospital Nova of Central Finland, Wellbeing Services County of Central Finland, Jyväskylä, Finland.
Quelle: Radiation oncology (London, England) [Radiat Oncol] 2024 Feb 13; Vol. 19 (1), pp. 21. Date of Electronic Publication: 2024 Feb 13.
Publikationsart: Journal Article
Sprache: English
Info zur Zeitschrift: Publisher: BioMed Central Country of Publication: England NLM ID: 101265111 Publication Model: Electronic Cited Medium: Internet ISSN: 1748-717X (Electronic) Linking ISSN: 1748717X NLM ISO Abbreviation: Radiat Oncol Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BioMed Central, 2006-
MeSH-Schlagworte: Radiotherapy, Intensity-Modulated*/methods , Spiral Cone-Beam Computed Tomography* , Radiotherapy, Conformal* , Radiotherapy, Image-Guided*/methods, Humans ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy Dosage ; Cone-Beam Computed Tomography/methods
Abstract: Background: The dosimetric effect of setup uncertainty and tissue deformations in left-sided whole-breast irradiation with complementary surface-guided radiotherapy (SGRT) and cone-beam computed tomography (CBCT) setup was evaluated.
Method: Treatment courses of 40.05 Gy prescribed dose in 15 fractions were simulated for 29 patients by calculating the dose on deformed CT images, that were based on daily CBCT images, and deforming and accumulating the dose onto the planning CT image. Variability in clinical target volume (CTV) position and shape was assessed as the 95% Hausdorff distance (HD95) between the planning CTV and deformed CTV structures. DVH metrics were evaluated between the planned and simulated cumulative dose distributions using two treatment techniques: tangential volumetric modulated arc therapy (tVMAT) and conventional 3D-conformal radiotherapy (3D-CRT).
Results: Based on the HD95 values, the variations in CTV shape and position were enclosed by the 5 mm CTV-PTV margin in 85% of treatment fractions using complementary CBCT and SGRT setup. A residual error of 8.6 mm was observed between the initial SGRT setup and CBCT setup. The median CTV V95% coverage was 98.1% (range 93.1-99.8%) with tVMAT and 98.2% (range 84.5-99.7%) with 3D-CRT techniques with CBCT setup. With the initial SGRT-only setup, the corresponding coverages were 96.3% (range 92.6-99.4%) and 96.6% (range 84.2-99.4%), respectively. However, a considerable bias in vertical residual error between initial SGRT setup and CBCT setup was observed. Clinically relevant changes between the planned and cumulative doses to organs-at-risk (OARs) were not observed.
Conclusions: The CTV-to-PTV margin should not be reduced below 5 mm even with daily CBCT setup. Both tVMAT and 3D-CRT techniques were robust in terms of dose coverage to the target and OARs. Based on the shifts between setup methods, CBCT setup is recommended as a complementary method with SGRT.
(© 2024. The Author(s).)
References: Radiat Oncol. 2021 Aug 3;16(1):143. (PMID: 34344403)
Rep Pract Oncol Radiother. 2018 Jan-Feb;23(1):61-67. (PMID: 29379398)
Radiat Oncol. 2019 Jul 11;14(1):125. (PMID: 31296245)
Phys Med. 2018 Jan;45:12-18. (PMID: 29472076)
Radiother Oncol. 2022 Aug;173:188-196. (PMID: 35661677)
J Appl Clin Med Phys. 2019 Mar;20(3):97-104. (PMID: 30861276)
Bioengineering (Basel). 2022 Mar 24;9(4):. (PMID: 35447691)
Int J Radiat Oncol Biol Phys. 2011 Apr 1;79(5):1557-64. (PMID: 20933341)
Radiat Oncol. 2022 Apr 15;17(1):76. (PMID: 35428265)
Int J Radiat Oncol Biol Phys. 2013 Feb 1;85(2):536-42. (PMID: 22652107)
Semin Radiat Oncol. 2004 Jan;14(1):52-64. (PMID: 14752733)
Radiat Oncol. 2015 Apr 08;10:79. (PMID: 25888866)
Med Dosim. 2022 Summer;47(2):146-150. (PMID: 35039223)
Sci Rep. 2018 May 8;8(1):7270. (PMID: 29740104)
Front Oncol. 2020 Oct 29;10:554131. (PMID: 33194616)
Lancet. 2020 May 23;395(10237):1613-1626. (PMID: 32580883)
Radiother Oncol. 2015 Jan;114(1):3-10. (PMID: 25630428)
Int J Radiat Oncol Biol Phys. 2010 Nov 15;78(4):1235-43. (PMID: 20472368)
Med Phys. 2011 Nov;38(11):6228-37. (PMID: 22047388)
Med Dosim. 2017 Autumn;42(3):177-184. (PMID: 28526193)
Strahlenther Onkol. 2023 Jan;199(1):22-29. (PMID: 35788694)
J Appl Clin Med Phys. 2022 Mar;23(3):e13493. (PMID: 35077004)
J Appl Clin Med Phys. 2017 Nov;18(6):58-61. (PMID: 28901684)
Lancet. 2008 Mar 29;371(9618):1098-107. (PMID: 18355913)
Int J Radiat Oncol Biol Phys. 1999 Mar 1;43(4):905-19. (PMID: 10098447)
Med Dosim. 2019 Summer;44(2):183-189. (PMID: 30135024)
Med Dosim. 2021 Spring;46(1):86-93. (PMID: 32994095)
Radiat Oncol. 2023 Apr 20;18(1):72. (PMID: 37081477)
Sci Rep. 2020 May 5;10(1):7550. (PMID: 32371862)
J Appl Clin Med Phys. 2018 Sep;19(5):506-516. (PMID: 29978548)
Phys Med. 2019 Sep;65:1-5. (PMID: 31430580)
Tech Innov Patient Support Radiat Oncol. 2022 Feb 17;21:51-57. (PMID: 35243045)
Contributed Indexing: Keywords: CBCT; Setup margin; Setup uncertainty; Tissue deformations; VMAT
Entry Date(s): Date Created: 20240212 Date Completed: 20240214 Latest Revision: 20240215
Update Code: 20250114
PubMed Central ID: PMC10863193
DOI: 10.1186/s13014-024-02418-5
PMID: 38347554
Datenbank: MEDLINE
Beschreibung
Abstract:Background: The dosimetric effect of setup uncertainty and tissue deformations in left-sided whole-breast irradiation with complementary surface-guided radiotherapy (SGRT) and cone-beam computed tomography (CBCT) setup was evaluated.<br />Method: Treatment courses of 40.05 Gy prescribed dose in 15 fractions were simulated for 29 patients by calculating the dose on deformed CT images, that were based on daily CBCT images, and deforming and accumulating the dose onto the planning CT image. Variability in clinical target volume (CTV) position and shape was assessed as the 95% Hausdorff distance (HD95) between the planning CTV and deformed CTV structures. DVH metrics were evaluated between the planned and simulated cumulative dose distributions using two treatment techniques: tangential volumetric modulated arc therapy (tVMAT) and conventional 3D-conformal radiotherapy (3D-CRT).<br />Results: Based on the HD95 values, the variations in CTV shape and position were enclosed by the 5 mm CTV-PTV margin in 85% of treatment fractions using complementary CBCT and SGRT setup. A residual error of 8.6 mm was observed between the initial SGRT setup and CBCT setup. The median CTV V95% coverage was 98.1% (range 93.1-99.8%) with tVMAT and 98.2% (range 84.5-99.7%) with 3D-CRT techniques with CBCT setup. With the initial SGRT-only setup, the corresponding coverages were 96.3% (range 92.6-99.4%) and 96.6% (range 84.2-99.4%), respectively. However, a considerable bias in vertical residual error between initial SGRT setup and CBCT setup was observed. Clinically relevant changes between the planned and cumulative doses to organs-at-risk (OARs) were not observed.<br />Conclusions: The CTV-to-PTV margin should not be reduced below 5 mm even with daily CBCT setup. Both tVMAT and 3D-CRT techniques were robust in terms of dose coverage to the target and OARs. Based on the shifts between setup methods, CBCT setup is recommended as a complementary method with SGRT.<br /> (© 2024. The Author(s).)
ISSN:1748-717X
DOI:10.1186/s13014-024-02418-5