A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Interfractional variation in whole-breast VMAT irradiation : a dosimetric study with complementary SGRT and CBCT patient setup (2024)
Mankinen, M., Virén, T., Seppälä, J., & Koivumäki, T. (2024). Interfractional variation in whole-breast VMAT irradiation : a dosimetric study with complementary SGRT and CBCT patient setup. Radiation Oncology, 19, Article 21. https://doi.org/10.1186/s13014-024-02418-5
JYU-tekijät tai -toimittajat
Julkaisun tiedot
Julkaisun kaikki tekijät tai toimittajat: Mankinen, M.; Virén, T.; Seppälä, J.; Koivumäki, T.
Lehti tai sarja: Radiation Oncology
eISSN: 1748-717X
Julkaisuvuosi: 2024
Ilmestymispäivä: 13.02.2024
Volyymi: 19
Artikkelinumero: 21
Kustantaja: Biomed Central
Julkaisumaa: Britannia
Julkaisun kieli: englanti
DOI: https://doi.org/10.1186/s13014-024-02418-5
Julkaisun avoin saatavuus: Avoimesti saatavilla
Julkaisukanavan avoin saatavuus: Kokonaan avoin julkaisukanava
Julkaisu on rinnakkaistallennettu (JYX): https://jyx.jyu.fi/handle/123456789/93573
Julkaisu on rinnakkaistallennettu: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863193
Tiivistelmä
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% Hausdorf 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 CTVPTV 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.
YSO-asiasanat: sädehoito; säteilyannokset; rintasyöpä; onkologia; kudokset; tietokonetomografia; hoitomenetelmät
Vapaat asiasanat: setup margin; setup uncertainty; tissue deformations; VMAT; CBCT
Liittyvät organisaatiot
OKM-raportointi: Kyllä
VIRTA-lähetysvuosi: 2024
Alustava JUFO-taso: 1