Optimizing image guidance frequency and implications on margins for gynecologic malignancies

Radiation Oncology

Simone Marnitz²  Christhardt Koehler¹  Volker Budach²  Waldemar Wlodarczyk²  Arne Gruen²  Carmen Stromberger² 

[1] Department of Gynecology, Charité Universitätsmedizin Berlin, Berlin, Germany;Department of Radiooncology, Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin 13353, Germany

关键词: Margin;    Image guidance;    Gynecological tumors;    Setup accuracy;    MVCT;    Helical tomotherapy;   

Others  :  1154024
DOI  :  10.1186/1748-717X-8-110

 received in 2013-03-08, accepted in 2013-04-19,  发布年份 2013

【 摘 要 】

Background

To analyze setup deviations using daily megavoltage computed tomography (MVCT) and to evaluate three MVCT frequency reducing protocols for gynecologic cancer patients treated with helical tomotherapy.

Methods

We recorded the setup errors of 56 patients with gynecological cancer observed throughout their whole course by matching their daily MVCT with the planning CT. Systematic and random errors were calculated on a patient and population basis. We defined three different protocols corresponding to MVCTs from the first five fractions (FFF), the first ten fractions (FTF) or from the first and third weeks (505). We compared theoretical. setup errors calculated using these 5 or 10 early MVCT scans with the actual errors found with the remaining fractions to to analyze the residual deviations.

Results

The total systematic (random) deviations had means of −2.0 (3.8)mm, 0.5 (3.4)mm, 0.5 (6.1)mm and −0.5° (0.9°) in vertical (V), longitudinal (LO), lateral (LA), and roll (R) directions, respectively. The proposed three MVCT protocols resulted in minor residual deviations. In all three protocols, 95% of all calculated residual deviations were less than or equal to 5 mm in all 3 directions. When examining the additional minimal CTV-PTV setup margins that were calculated based on these residual deviations, the 505 protocol would have allowed smaller margins than the FFF and FTF protocol, particularly in the V direction.

Conclusions

For patients with gynecologic cancer, the 505-protocol led to the lowest residual deviations and therefore might offer the best approach in reducing the frequency of pre-treatment MVCTs.

【 授权许可】

   
2013 Stromberger et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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