Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT).
Authors
Jain, PoojaMarchant, 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
Affiliation
Academic Department of Radiation Oncology, The University of Manchester, Manchester M20 4BX, UK.Issue Date
2009-01
Metadata
Show full item recordAbstract
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.Citation
Inter-fraction motion and dosimetric consequences during breast intensity-modulated radiotherapy (IMRT). 2009, 90 (1):93-8 Radiother OncolJournal
Radiotherapy and OncologyDOI
10.1016/j.radonc.2008.10.010PubMed ID
19012980Type
ArticleLanguage
enISSN
0167-8140ae974a485f413a2113503eed53cd6c53
10.1016/j.radonc.2008.10.010