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Positioning accuracy during VMAT of gynecologic malignancies and the resulting dosimetric impact by a 6-degree-of-freedom couch in combination with daily kilovoltage cone beam computed tomography
Yao, Lihong; Zhu, Lihong; Wang, Junjie; Liu, Lu; Zhou, Shun; Jiang, ShuKun; Cao, Qianqian; Qu, Ang; Tian, Suqing
刊名RADIATION ONCOLOGY
2015-04-26
DOI10.1186/s13014-015-0412-x
10
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Oncology ; Radiology, Nuclear Medicine & Medical Imaging
研究领域[WOS]Oncology ; Radiology, Nuclear Medicine & Medical Imaging
关键词[WOS]MODULATED RADIATION-THERAPY ; IMAGE-GUIDED RADIOTHERAPY ; WHOLE PELVIC RADIOTHERAPY ; CERVICAL-CANCER PATIENTS ; ORGAN MOTION ; PATIENT SETUP ; SMALL-BOWEL ; ERRORS ; MARGINS ; TARGET
英文摘要

Background: To improve the delivery of radiotherapy in gynecologic malignancies and to minimize the irradiation of unaffected tissues by using daily kilovoltage cone beam computed tomography (kV-CBCT) to reduce setup errors.

Methods: Thirteen patients with gynecologic cancers were treated with postoperative volumetric-modulated arc therapy (VMAT). All patients had a planning CT scan and daily CBCT during treatment. Automatic bone anatomy matching was used to determine initial inter-fraction positioning error. Positional correction on a six-degrees-of-freedom (6DoF) couch was followed by a second scan to calculate the residual inter-fraction error, and a post-treatment scan assessed intra-fraction motion. The margins of the planning target volume (M-PTV) were calculated from these setup variations and the effect of margin size on normal tissue sparing was evaluated.

Results: In total, 573 CBCT scans were acquired. Mean absolute pre-/post-correction errors were obtained in all six planes. With 6DoF couch correction, the MPTV accounting for intra-fraction errors was reduced by 3.8-5.6 mm. This permitted a reduction in the maximum dose to the small intestine, bladder and femoral head (P = 0.001, 0.035 and 0.032, respectively), the average dose to the rectum, small intestine, bladder and pelvic marrow (P = 0.003, 0.000, 0.001 and 0.000, respectively) and markedly reduced irradiated normal tissue volumes.

Conclusions: A 6DoF couch in combination with daily kV-CBCT can considerably improve positioning accuracy during VMAT treatment in gynecologic malignancies, reducing the MPTV. The reduced margin size permits improved normal tissue sparing and a smaller total irradiated volume.

语种英语
WOS记录号WOS:000355076000001
引用统计
被引频次:3[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/66991
专题北京大学第三临床医学院_肿瘤放疗科
北京大学第三临床医学院_肿瘤治疗中心
北京大学精神卫生研究所_护理部
作者单位Peking Univ, Hosp 3, Dept Radiat Oncol, Beijing 100191, Peoples R China
推荐引用方式
GB/T 7714
Yao, Lihong,Zhu, Lihong,Wang, Junjie,et al. Positioning accuracy during VMAT of gynecologic malignancies and the resulting dosimetric impact by a 6-degree-of-freedom couch in combination with daily kilovoltage cone beam computed tomography[J]. RADIATION ONCOLOGY,2015,10.
APA Yao, Lihong.,Zhu, Lihong.,Wang, Junjie.,Liu, Lu.,Zhou, Shun.,...&Tian, Suqing.(2015).Positioning accuracy during VMAT of gynecologic malignancies and the resulting dosimetric impact by a 6-degree-of-freedom couch in combination with daily kilovoltage cone beam computed tomography.RADIATION ONCOLOGY,10.
MLA Yao, Lihong,et al."Positioning accuracy during VMAT of gynecologic malignancies and the resulting dosimetric impact by a 6-degree-of-freedom couch in combination with daily kilovoltage cone beam computed tomography".RADIATION ONCOLOGY 10(2015).
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