Re-irradiation of spinal column metastases by IMRT: impact of setup errors on the dose distribution

Radiation Oncology

Barbara Dobler²  Oliver Kölbl²  Natalia Repp¹  Rainer Loeschel¹  Matthias G Hautmann²  Christian Gröger² 

[1] Department of Computer Science and Mathematics, University of Applied Sciences, Regensburg, Germany;Department of Radiotherapy, University Medical Center, Regensburg, Germany

关键词: Spinal metastasis;    IMRT;    IGRT;    Setup error;    CBCT;   

Others  :  829717
DOI  :  10.1186/1748-717X-8-269

 received in 2013-04-26, accepted in 2013-11-03,  发布年份 2013

【 摘 要 】

Background

This study investigates the impact of an automated image guided patient setup correction on the dose distribution for ten patients with in-field IMRT re-irradiation of vertebral metastases.

Methods

10 patients with spinal column metastases who had previously been treated with 3D-conformal radiotherapy (3D-CRT) were simulated to have an in-field recurrence. IMRT plans were generated for treatment of the vertebrae sparing the spinal cord. The dose distributions were compared for a patient setup based on skin marks only and a Cone Beam CT (CBCT) based setup with translational and rotational couch corrections using an automatic robotic image guided couch top (Elekta - HexaPOD™ IGuide^® - system). The biological equivalent dose (BED) was calculated to evaluate and rank the effects of the automatic setup correction for the dose distribution of CTV and spinal cord.

Results

The mean absolute value (± standard deviation) over all patients and fractions of the translational error is 6.1 mm (±4 mm) and 2.7° (±1.1 mm) for the rotational error. The dose coverage of the 95% isodose for the CTV is considerable decreased for the uncorrected table setup. This is associated with an increasing of the spinal cord dose above the tolerance dose.

Conclusions

An automatic image guided table correction ensures the delivery of accurate dose distribution and reduces the risk of radiation induced myelopathy.

【 授权许可】

   
2013 Gröger et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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