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学科主题: 临床医学
题名:
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
作者: Yao, Lihong; Zhu, Lihong; Wang, Junjie; Liu, Lu; Zhou, Shun; Jiang, ShuKun; Cao, Qianqian; Qu, Ang; Tian, Suqing
刊名: RADIATION ONCOLOGY
发表日期: 2015-04-26
DOI: 10.1186/s13014-015-0412-x
卷: 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
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/66991
Appears in Collections:北京大学第三临床医学院_肿瘤放疗科_期刊论文

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作者单位: Peking Univ, Hosp 3, Dept Radiat Oncol, Beijing 100191, Peoples R China

Recommended Citation:
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.
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