|Table of Contents|

Comparison in the positioning accuracy of plastic pad combined with head,neck and shoulder membrane fixation in radiotherapy for head and neck cancer with and without standard plastic pillow

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

Issue:
2023 22
Page:
4221-4224
Research Field:
Publishing date:

Info

Title:
Comparison in the positioning accuracy of plastic pad combined with head,neck and shoulder membrane fixation in radiotherapy for head and neck cancer with and without standard plastic pillow
Author(s):
WU Yu; GUO Xijing; ZHAO Peizhu; ZHANG Rui; ZHOU Hua
Department of Oncology Radiotherapy,the First Affiliated Hospital of Kunming Medical University，Yunnan Kunming 650000，China.
Keywords:
immobilization; head and neck cancer; radiotherapy; set-up error; margin of planning target volume
PACS:
R730.55
DOI:
10.3969/j.issn.1672-4992.2023.22.023
Abstract:
Objective:To analyze the differences in the positioning accuracy of plastic pad combined with head,neck and shoulder membrane fixation in radiotherapy for head and neck cancer with and without standard plastic pillow,to provide reference for clinical decision-making.Methods:Totally 167 patients with head and neck cancer who underwent radiotherapy in our hospital from January 1,2022 to December 31,2022 were selected as the research objects.Among them,73 patients were treated with TOMO,of which 26 patients were treated without standard plastic pillow(A1 group),and 47 patients were treated with standard plastic pillow(A2 group).94 patients were treated with VMAT,of which 37 patients without standard plastic pillow(B1 group),and 57 patients with standard plastic pillow(B2 group).Megavolt fan-beam CT scanning and bone-based registration were performed before TOMO treatment.Similarly,kilovolt cone-beam CT scanning and bone-based & gray-based registration were performed before VMAT treatment.All patients underwent CT scan before radiotherapy to obtain X-axis (left-right),Y-axis (head-to-foot),and Z-axis (anterior-posterior) set-up errors.The margin of planning target volume (MPTV) was calculated by formula:MPTV=2.5Σ+0.7σ.Results:Totally 1 396 set-up errors were obtained:X-axis (0.08±0.24) mm,Y-axis (0.14±0.4) mm,Z-axis (0.15±0.47) mm for A1 group,X-axis (0.49±2.02) mm,Y-axis (0.22±0.7) mm,Z-axis (0.12±0.45) mm for A2 group.There were significant differences in set-up errors between the two groups in the direction of X and Y (P<0.001).The set-up errors were X-axis (0.04±0.24) mm,Y-axis (0.15±0.3) mm,Z-axis (-0.2±0.38) mm for B1 group,X-axis (0.19±0.54) mm,Y-axis (0.1±0.49) mm,Z-axis (-0.19±0.43) mm for B2 group.There were significant differences in set-up errors in three directions between the two groups (P<0.05).MPTV in the X-axis,Y-axis and Z-axis for TOMO A1 group was 2.36 mm,3.47 mm and 1.83 mm respectively,3.04 mm,4.79 mm,1.61 mm for TOMO A2 group,2.72 mm,2.80 mm,1.95 mm for VMAT B1 group,3.70 mm,3.54 mm and 2.92 mm for VMAT B2 group,respectively.The MPTV of the standard plastic pillow free group was smaller than that in the standard plastic pillow group on the X and Y axes,and the homogeneity of MPTV in the three directions was better than that in the standard plastic pillow group.Conclusion:The use of plastic pad combined with head,neck and shoulder membrane fixation in radiotherapy for head and neck cancer without standard plastic pillow fixation can reduce the set-up errors and MPTV in the left-right and head-to-foot directions,and increase the uniformity of the MPTV in radiotherapy for head and neck cancer.

References:

[1] LAMBERT EM,GUNN GB,GIDLEY PW.Effects of radiation on the temporal bone in patients with head and neck cancer［J］.Head Neck,2016,38(9):1428-1435.
[2] VAN HERK M.Errors and margins in radiotherapy［J］.Semin Radiat Oncol,2004,14(1):52-64.
[3] STROOM JC,HEIJMEN BJ.Geometrical uncertainties,radiotherapy planning margins,and the ICRU-62 report［J］.Radiother Oncol,2002,64(1):75-83.
[4] 李洪明,于浪,孙显松,等.MVCT引导下螺旋断层调强放射治疗摆位误差及靶区边界外放分析［J］.中国医学装备,2017,14(7):55-58. LI HM,YU L,SUN XS,et al.Analysis of positioning errors and margin of target region of intensity modulated helical tomotherapy under guidance of MVCT［J］.China Medical Equipment,2017,14(7):55-58.
[5] OHNLEITER T,ANTONI D,LEFEBVRE F,et al.Factors improving the outcome of patients re-irradiated with intensity-modulated radiotherapy (IMRT) for relapse or new head and neck cancer developed in irradiated areas［J］.Chin Clin Oncol,2018,7(6):60.
[6]黄家文,张梅芳,刘利彬,等.鼻咽癌放疗旋转与平移误差的相关性［J］.中国医学物理学杂志,2018,35(12):1365-1370. HUANG JW,ZHANG MF,LIU LB,et al.Correlation between rotational errors and translational errors in intensity-modulated radiotherapy for nasopharyngeal carcinoma［J］.Chinese Journal of Medical Physics,2018,35(12):1365-1370.
[7] 高云生.图像引导的头颈部肿瘤放射治疗［D］.上海：复旦大学,2010. GAO YS.Image-guided radiation therapy for head and neck tumors［D］.Shanghai:Fudan University,2010.
[8] 张校铭,秦勤,李军烽,等.4种不同固定技术在头颈部肿瘤放疗中的摆位误差比较［J］.医疗卫生装备,2021,42(08):49-52. ZHANG XM,QIN Q,LI JF,et al.Comparison of setup errors using four different immobilization techniques for radiotherapy of patients with head and neck tumors［J］.Chinese Medical Equipment Journal,2021,42(08):49-52.
[9] 刘礼东,杨振,钟美佐,等.肿瘤放疗中塑形垫结合热塑网膜体位固定方式的摆位误差研究［J］.中国肿瘤临床,2020,47(04):198-201. LIU LD,YANG Z,ZHONG MZ,et al.Analysis of setup errors in patients using the customized Klarity AccuCushion with a thermoplastic fixation mask while receiving radiotherapy［J］.Chin J Clin Oncol,2020,47(04):198-201.
[10] VAN LIN EN,VAN DER VIGHT L,HUIZENGA H,et al.Set-up improvement in head and neck radiotherapy using a 3D off-line EPID-based correction protocol and a customised head and neck support［J］.Radiother Oncol,2003,68(2):137-148.
[11] 闫昱萤,叶荣,于路新,等.3D打印头枕提高了鼻咽癌调强放疗体位重复性［J］.现代肿瘤医学,2023,31(08):1485-1489. YAN YY,YE R,YU LX,et al.The 3D printed headrest improves the repeatability of the position of intensity-modulated radiotherapy for nasopharyngeal carcinoma［J］.Modern Oncology,2023,31(08):1485-1489.
[12] 吴冰,马广栋,王亮和.图像引导放射治疗技术不同验证模式对头颈部肿瘤调强放疗摆位误差的影响［J］.广西医学,2019,41(01):63-66. WU B,MA GD,WANG LH,et al.Effects of different verification modes of image-guided radiotherapy on the positioning errors of intensity-modulated radiotherapy for head and neck tumors［J］.Guangxi Medical Journal,2019,41(01):63-66.
[13] 张萍,虞维博,许青,等.探究体质量指数对鼻咽癌患者放疗摆位误差的影响［J］.中国癌症杂志,2018,28(05):389-393. ZHANG P,YU WB,XU Q,et al.Exploration of the impact of body mass index on radiotherapy setup error in nasopharyngeal carcinoma patients［J］.China Oncology,2018,28(05):389-393.
[14] 许海富,邓乒翻.分析体质量指数对鼻咽癌患者放疗摆位误差产生的影响［J］.中国实用医药,2019,14(30):19-21. XU HF,DENG PF.Analysis of the influence of body mass index on the positioning error of nasopharyngeal carcinoma patients during radiotherapy［J］.China Practical Medicine,2019,14(30):19-21.
[15] HOU WH,WANG CW,TSAI CL,et al.The ratio of weight loss to planning target volume significantly impacts setup errors in nasopharyngeal cancer patients undergoing helical tomotherapy with daily megavoltage computed tomography［J］.Radiol Oncol,2016,50(4):427-432.

Memo

Memo:
-
Last Update: 1900-01-01