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Strahlentherapie und Onkologie

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01.04.2013 | Original article

Impact of inter- and intrafraction deviations and residual set-up errors on PTV margins

Different alignment techniques in 3D conformal prostate cancer radiotherapy

verfasst von: Prof. T. Langsenlehner, M.D., C. Döller, P. Winkler, G. Gallé, K.S. Kapp

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 4/2013

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Abstract

Purpose

The aim of this work was to analyze interfraction and intrafraction deviations and residual set-up errors (RSE) after online repositioning to determine PTV margins for 3 different alignment techniques in prostate cancer radiotherapy.

Methods

The present prospective study included 44 prostate cancer patients with implanted fiducials treated with three-dimensional (3D) conformal radiotherapy. Daily localization was based on skin marks followed by marker detection using kilovoltage (kV) imaging and subsequent patient repositioning. Additionally, in-treatment megavoltage (MV) images were obtained for each treatment field. In an off-line analysis of 7,273 images, interfraction prostate motion, RSE after marker-based prostate localization, prostate position during each treatment session, and the effect of treatment time on intrafraction deviations were analyzed to evaluate PTV margins.

Results

Margins accounting for interfraction deviation, RSE and intrafraction motion were 14.1, 12.9, and 15.1 mm in anterior–posterior (AP), superior–inferior (SI), and left–right (LR) direction for skin mark alignment and 9.6, 8.7, and 2.6 mm for bony structure alignment, respectively. Alignment to implanted markers required margins of 4.6, 2.8, and 2.5 mm. As margins to account for intrafraction motion increased with treatment prolongation PTV margins could be reduced to 3.9, 2.6, and 2.4 mm if treatment time was ≤ 4 min.

Conclusion

With daily online correction and repositioning based on implanted fiducials, a significant reduction of PTV margins can be achieved. The use of an optimized workflow with faster treatment techniques such as volumetric modulated arc techniques (VMAT) could allow for a further decrease.

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Titel: Impact of inter- and intrafraction deviations and residual set-up errors on PTV margins
Different alignment techniques in 3D conformal prostate cancer radiotherapy
verfasst von: Prof. T. Langsenlehner, M.D.
C. Döller
P. Winkler
G. Gallé
K.S. Kapp
Publikationsdatum: 01.04.2013
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 4/2013
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-012-0303-0

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Impact of inter- and intrafraction deviations and residual set-up errors on PTV margins

Different alignment techniques in 3D conformal prostate cancer radiotherapy

Abstract

Purpose

Methods

Results

Conclusion

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Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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