Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT).

2.50
Hdl Handle:
http://hdl.handle.net/10541/69736
Title:
Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT).
Authors:
Jain, Pooja; Marchant, Thomas E; Green, Melanie M; Watkins, Gillian R; Davies, Julie; McCarthy, Claire; Loncaster, Juliette A; Stewart, Alan L; Magee, Brian; Moore, Christopher J; Price, Patricia M
Abstract:
BACKGROUND AND PURPOSE: Intensity-modulated radiotherapy (IMRT) can improve dose homogeneity within the breast planned target volume (PTV), but may be more susceptible to patient/organ motion than standard tangential radiotherapy (RT). We used daily cone-beam CT (CBCT) imaging to assess inter-fraction motion during breast IMRT and its subsequent impact on IMRT and standard RT dose homogeneity. MATERIALS AND METHODS: Ten breast cancer patients selected for IMRT were studied. CBCT images were acquired immediately after daily treatment. Automatic image co-registration was used to determine patient positioning variations. Daily PTV contours were used to calculate PTV variations and daily delivered IMRT and theoretically planned tangential RT dose. RESULTS: Group systematic (and random) setup errors detected by CBCT were 5.7 (3.9)mm laterally, 2.8 (3.5)mm vertically and 2.3 (3.2)mm longitudinally. Rotations >2 degrees in any axis occurred on 53/106 (50%) occasions. Daily PTV volume varied up to 23%. IMRT dose homogeneity was superior at planning and throughout the treatment compared with standard RT (1.8% vs. 15.8% PTV received >105% planned mean dose), despite increased motion sensitivity. CONCLUSIONS: CBCT revealed inadequacies of current patient positioning and verification procedures during breast RT and confirmed improved dose homogeneity using IMRT for the patients studied.
Affiliation:
Academic Department of Radiation Oncology, The University of Manchester, Manchester M20 4BX, UK.
Citation:
Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT). 2009, 90 (1):93-8 Radiother Oncol
Journal:
Radiotherapy and Oncology
Issue Date:
Jan-2009
URI:
http://hdl.handle.net/10541/69736
DOI:
10.1016/j.radonc.2008.10.010
PubMed ID:
19012980
Type:
Article
Language:
en
ISSN:
0167-8140
Appears in Collections:
All Christie Publications ; Christie Medical Physics and Engineering Research; Clinical Oncology; Academic Department of Radiation Oncology - ADRO

Full metadata record

DC FieldValue Language
dc.contributor.authorJain, Pooja-
dc.contributor.authorMarchant, Thomas E-
dc.contributor.authorGreen, Melanie M-
dc.contributor.authorWatkins, Gillian R-
dc.contributor.authorDavies, Julie-
dc.contributor.authorMcCarthy, Claire-
dc.contributor.authorLoncaster, Juliette A-
dc.contributor.authorStewart, Alan L-
dc.contributor.authorMagee, Brian-
dc.contributor.authorMoore, Christopher J-
dc.contributor.authorPrice, Patricia M-
dc.date.accessioned2009-06-04T14:36:05Z-
dc.date.available2009-06-04T14:36:05Z-
dc.date.issued2009-01-
dc.identifier.citationInter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT). 2009, 90 (1):93-8 Radiother Oncolen
dc.identifier.issn0167-8140-
dc.identifier.pmid19012980-
dc.identifier.doi10.1016/j.radonc.2008.10.010-
dc.identifier.urihttp://hdl.handle.net/10541/69736-
dc.description.abstractBACKGROUND AND PURPOSE: Intensity-modulated radiotherapy (IMRT) can improve dose homogeneity within the breast planned target volume (PTV), but may be more susceptible to patient/organ motion than standard tangential radiotherapy (RT). We used daily cone-beam CT (CBCT) imaging to assess inter-fraction motion during breast IMRT and its subsequent impact on IMRT and standard RT dose homogeneity. MATERIALS AND METHODS: Ten breast cancer patients selected for IMRT were studied. CBCT images were acquired immediately after daily treatment. Automatic image co-registration was used to determine patient positioning variations. Daily PTV contours were used to calculate PTV variations and daily delivered IMRT and theoretically planned tangential RT dose. RESULTS: Group systematic (and random) setup errors detected by CBCT were 5.7 (3.9)mm laterally, 2.8 (3.5)mm vertically and 2.3 (3.2)mm longitudinally. Rotations >2 degrees in any axis occurred on 53/106 (50%) occasions. Daily PTV volume varied up to 23%. IMRT dose homogeneity was superior at planning and throughout the treatment compared with standard RT (1.8% vs. 15.8% PTV received >105% planned mean dose), despite increased motion sensitivity. CONCLUSIONS: CBCT revealed inadequacies of current patient positioning and verification procedures during breast RT and confirmed improved dose homogeneity using IMRT for the patients studied.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshBreast Neoplasms-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLinear Models-
dc.subject.meshMotion-
dc.subject.meshPosture-
dc.subject.meshProspective Studies-
dc.subject.meshRadiography, Interventional-
dc.subject.meshRadiotherapy Dosage-
dc.subject.meshRadiotherapy Planning, Computer-Assisted-
dc.subject.meshRadiotherapy, Intensity-Modulated-
dc.subject.meshTomography, X-Ray Computed-
dc.subject.meshTreatment Outcome-
dc.titleInter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT).en
dc.typeArticleen
dc.contributor.departmentAcademic Department of Radiation Oncology, The University of Manchester, Manchester M20 4BX, UK.en
dc.identifier.journalRadiotherapy and Oncologyen

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