|Table of Contents|

Application of reference point labeling guided and localized by multiplanar reformation image in the localization of cervical cancer radiotherapy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 19
Page:
3634-3639
Research Field:
Publishing date:

Info

Title:
Application of reference point labeling guided and localized by multiplanar reformation image in the localization of cervical cancer radiotherapy
Author(s):
CHENG Zhaojie; LIU Guangming; WEI Ting; LIANG Weixue; SU Ting; WANG Zhanyu
Department of Oncology，the Fourth Affiliated Hospital of Guangxi Medical University/Liuzhou Workers Hospital,Guangxi Liuzhou 545005,China.
Keywords:
cervical cancer; positioning error; radiotherapy localization; reference point marking method
PACS:
R737.33
DOI:
10.3969/j.issn.1672-4992.2023.19.019
Abstract:
Objective:To investigate the application value of reference point labeling guided and localized by multiplanar reformation(MPR) image in the localization of cervical cancer radiotherapy.Methods:A total of 40 patients with cervical cancer who underwent volumetric modulated arc therapy(VMAT) in the tumor radiotherapy center of our hospital from May to December 2022 were selected and divided into observation group and control group by random number table method,with 20 cases in each group.The patients in the observation group used the reference point labeling guided and localized by MPR image to locate,and those in the control group used conventional reference point labeling to locate.In the design of VMAT radiotherapy plan,according to the selection principle of ICRU reference point,the prescribed point of dose normalization in the target area was selected as the central point of treatment.The number of patients in which the displacement between the treatment center point and the positioning reference point was compared between the two groups,and the displacement rate(%) was described.Conical beam CT(CBCT) scanning position verification was performed at the first treatment and once a week after the first treatment for all patients(a total of 5 times).The positioning error data of left and right X,head and foot Y,abdominal and dorsal Z directions between the two groups and the time to complete reset were collected respectively,and independent sample t test was used.P<0.05 was considered statistically significant.The formula to calculate margin planning target volume(MPTV),MPTV= 2.5∑+0.7σ,was used to calculate the external boundary of the target under different positioning methods.Results:In the observation group,0 case of positioning reference point and treatment center point had displacement in the three-dimensional direction,while in the control group,11 cases and 19 cases had displacement in the Y direction and Z direction,with displacement rates of 55% and 95%,respectively.The average positioning errors of the observation group were X(-0.16±1.99)mm,Y(1.04±4.13)mm and Z(0.77±2.30)mm,respectively.The average errors of the control group were X(0.18±2.59)mm,Y(-2.09±5.02)mm and Z(1.44±2.39)mm,respectively.The positioning errors in Y and Z directions were statistically significant between the two groups(P<0.05).The average reset time of the observation group was (9.76±2.35)min and that of the control group was (13.25±3.66)min.The reset efficiency of the observation group was higher than that of the control group.The MPTV values of the observation group were 3.82 mm,7.28 mm and 4.55 mm,respectively,which were reduced by 18.20%,22.06% and 6.38% compared with the control group.Conclusion:The use of reference point labeling guided and localized by MPR image in the localization of cervical cancer radiotherapy can realize the same center of the located reference point and treatment center point,improve the efficiency of positioning,reduce positioning errors and narrow the MPTV,and thus is worth popularizing.

References:

［1］张爽,张明,王跃欣,等.宫颈鳞状细胞癌乳腺转移3例报道并文献复习［J］.现代肿瘤医学,2023,31(02):305-310.ZHANG S，ZHANG M，WANG YX，et al.Breast metastasis of cervical squamous cell carcinoma：Report of 3 cases and literature review［J］.Modern Oncology,2023,31(02):305-310.
［2］ARBYN M,WEIDERPASS E,BRUNI L,et al.Estimates of incidence and mortality of cervical cancer in 2018:a worldwide analysis［J］.Lancet Glob Health,2020,8(2):e191-e203.
［3］中国抗癌协会妇科肿瘤专业委员会.子宫颈癌诊断与治疗指南(2021年版)［J］.中国癌症杂志,2021,31(6):474-489.Chinese Gynecologic Cancer Society.Guidelines for the diagnosis and management of cervical cancer(2021 edition)［J］.China Oncology,2021,31(6):474-489.
［4］GAFFNEY DK,HASHIBE M,KEPKA D,et al.Too many women are dying from cervix cancer:Problems and solutions［J］.Gynecol Oncol,2018,151(3):547-554.
［5］徐慧军,段学章.现代肿瘤放射物理与技术［M］.北京:中国原子能出版社,2017:493.XU HJ,DUAN XZ.The physics and technology of modern radiation oncology［M］.Beijing:China Atomic Energy Press,2017:493.
［6］YUAN Y,CHANG XB,HU LJ,et al.Effect of isocenter deviation on volume modulated arc therapy plan results and gamma passing rate in the treatment of cervical cancer［J］.TCR,2021,10(10):4403-4412.
［7］邓佳,吴湘阳,常晓斌,等.容积旋转调强放疗中射野等中心选择对宫颈癌剂量学的影响［J］.现代肿瘤医学,2022,30(1):101-106.DENG J,WU XY,CHANG XB,et al.The dosimetry effect of the different positions of isocenter for volumetric modulated arc therapy treatment of cervical cancer［J］.Modern Oncology,2022,30(1):101-106.
［8］孙博,陈星宇,庞得全.脑胶质瘤术后容积旋转调强放射治疗计划中CT模拟定位技术确定治疗等中心可行性研究［J］.中国医学装备,2023,20(2):13-18.SUN B,CHEN XY,PANG DQ.Study on the feasibility of using CT Sim of VMAT plan after the surgery of glioma in determining isocenter of treatment［J］.China Medical Equipment,2023,20(2):13-18.
［9］钟强,覃文,王仁生.应用KV CBCT行鼻咽癌调强放射治疗定位点与治疗点同中心的对比研究［J］.现代肿瘤医学,2022,30(16):2999-3004.ZHONG Q,QIN W,WANG RS.A comparative study of focal point and treatment point of intensity modulated radiotherapy for nasopharyngeal carcinoma with KV CBCT［J］.Modern Oncology,2022,30(16):2999-3004.
［10］中华医学会放射肿瘤治疗学分会放疗技术学组,中国医师协会医学技师专业委员会.CT模拟定位技术临床操作指南中国专家共识(2021版)［J］.中华放射肿瘤学杂志,2021,30(6):535-542.Radiotherapy Technology Group of Radiation Oncology Branch of Chinese Medical Association,Medical Technician Professional Committee of Chinese Medical Doctor Association.Chinese expert consensus on clinical operation guidelines of CT simulation positioning technology(2021 edition)［J］.Chin J Radiat Oncol,2021,30(6):535-542.
［11］韦婷,成肇杰,梁卫学,等.CT管电流调节CARE Dose 4D技术在宫颈癌放射治疗定位中的价值［J］.中国医学装备,2023,20(3):6-10.WEI T,CHENG ZJ,LIANG WX,et al.Clinical value of CARE Dose 4D technique in radiotherapy localization of cervical cancer［J］.China Medical Equipment,2023,20(3):6-10.
［12］ROSARIO T,VAN DER WEIDE L,ADMIRAAL M,et al.Toward planning target volume margin reduction for the prostate using intrafraction motion correction with online kV imaging and automatic detection of implanted gold seeds［J］.Pract Radiat Oncol,2018,8（6）:422-428.
［13］胡逸民.肿瘤放射物理学［M］.北京:原子能出版社,1999:340-341.HU YM.The physics of radiation oncology［M］.Beijing:Atomic Energy Press,1999:340-341.
［14］MANDAL A,ASTHANA AK,PRADHAN S,et al.Search of an ideal location of isocenter in intensity-modulated radiotherapy treatment plans:A dosimetrical approach［J］.J Cancer Res Ther,2019,15(1):211-215.
［15］马平平,伍海彪,叶芝甫,等.体膜固定宫颈癌55例放疗腹部皮下脂肪厚度与体积对摆位误差影响［J］.中华肿瘤防治杂志,2020,27(13):1088-1093.MA PP,WU HB,YE ZF,et al.Effect of thickness and volume of abdominal subcutaneous fat in 55 patients with cervical cancer treated by thermoplastic mask fixation on setup error［J］.Chin J Cancer Prev Treat,2020,27(13):1088-1093.
［16］刘培,朱建国,王云刚,等.胸中上段食管癌锥形束CT两处参考点标记位置摆位误差研究［J］.中华肿瘤防治杂志,2017,24(07):464-467.LIU P,ZHU JG,WANG YG,et al.Setup errors by CBCT with selecting two different reference point marking positions for super and middle part of esophageal carcinoma in chest［J］.Chin J Cancer Prev Treat,2017,24(07):464-467.
［17］WU WC,CHANG YR,LAI YL,et al.Impact of body-mass factors on setup displacement during pelvic irradiation in patients with lower abdominal cancer［J］.Radio Oncol,2019,53(2):256-264.
［18］DELISHAJ D,URSINO S,PASQUALETTI F,et al.Set-up errors in head and neck cancer treated with IMRT technique assessed by cone-beam computed tomography:a feasible protocol［J］.Radiat Oncol J,2018,36(1):54-62.
［19］LETTMAIER S,LOTTER M,KREPPNER S,et al.Long term results of a prospective dose escalation phase-II trial:Interstitial pulsed-dose-rate brachytherapy as boost for intermediate-and high-risk prostate cancer［J］.Radiother Oncol,2012,104(2):181-186.
［20］VAN HERK M,REMEIJER P,RASCH C,et al.The probability of correct target dosage:dose-population histograms for deriving treatment margins in radiotherapy［J］.Int J Radiat Oncol,2000,47(4):1121-1135.
［21］STROOM JC,DE BOER HC,HUIZENGA H,et al.Inclusion of geometrical uncertainties in radiotherapy treatment planning by means of coverage probability［J］.Int J Radiat Oncol,1999,43(4):905-919.

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Last Update: 2023-08-31