Assessment of set-up errors in the radiotherapy of patients with head and neck cancer: standard vs. individual head support

Androjna, Sabina; Marciuš, Valerija Žager; Peterlin, Primož; Strojan, Primož

doi:10.2478/raon-2020-0036

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…Androjna et al. 11 results also reflect those found in our study, the authors found a statistically significant decrease in set up errors on a CHR compared to SHR in a large sample of 120 patients. The greatest reduction was seen in the vertical direction of 0.7 mm.…”

Section: Discussionsupporting

confidence: 92%

A retrospective analysis comparing set up errors from standard versus customised headrests for head and neck radiotherapy

et al. 2022

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Section: Discussionsupporting

confidence: 92%

A retrospective analysis comparing set up errors from standard versus customised headrests for head and neck radiotherapy

et al. 2022

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“…When using SGRT‐only patient setup and motion monitoring, the patient immobilization device is important, and here, the SGRT‐only setup accuracy is derived from the CDR system with customized head mold and open‐face mask. It has been reported that patient setup accuracy is higher using individual customized head support compared with standard headrest 31 . In addition, the customized head immobilization system also provides much higher patient motion restriction, reducing possible intrafractional patient motion.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that patient setup accuracy is higher using individual customized head support compared with standard headrest. 31 In addition, the customized head immobilization system also provides much higher patient motion restriction, reducing possible intrafractional patient motion.…”

Section: B | Clinical Benefits For Sgrt-only Setup and Option For Motion Monitoringmentioning

confidence: 99%

Accuracy of surface‐guided patient setup for conventional radiotherapy of brain and nasopharynx cancer

Lee

Huang

Zhang

et al. 2021

J Applied Clin Med Phys

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To evaluate the accuracy of surface-guided radiotherapy (SGRT) in cranial patient setup by direct comparison between optical surface imaging (OSI) and conebeam computed tomography (CBCT), before applying SGRT-only setup for conventional radiotherapy of brain and nasopharynx cancer. Methods and Materials: Using CBCT as reference, SGRT setup accuracy was examined based on 269 patients (415 treatments) treated with frameless cranial stereotactic radiosurgery (SRS) during 2018-2019. Patients were immobilized in customized head molds and open-face masks and monitored using OSI during treatment. The facial skin area in planning CT was used as OSI region of interest (ROI)for automatic surface alignment and the skull was used as the landmark for automatic CBCT/CT registration. A 6 degrees of freedom (6DOF) couch was used.Immediately after CBCT setup, an OSI verification image was captured, recording the SGRT setup differences. These differences were analyzed in 6DOFs and as a function of isocenter positions away from the anterior surface to assess OSI-ROI bias. The SGRT in-room setup time was estimated and compared with CBCT and orthogonal 2D kilovoltage (2DkV) setups. Results:The SGRT setup difference (magnitude) is found to be 1.0 AE 2.5 mm and 0.1˚AE1.4˚on average among 415 treatments and within 5 mm/3˚with greater than 95% confidence level (P < 0.001). Outliers were observed for very-posterior isocenters: 15 differences (3.6%) are >5.0mm and 9 (2.2%) are >3.0˚. The setup differences show minor correlations (|r| < 0.45) between translational and rotational DOFs and a minor increasing trend (<1.0 mm) in the anterior-to-posterior direction.The SGRT setup time is 0.8 AE 0.3 min, much shorter than CBCT (5 AE 2 min) and 2DkV (2 AE 1 min) setups. Conclusion:This study demonstrates that SGRT has sufficient accuracy for fast inroom patient setup and allows real-time motion monitoring for beam holding during treatment, potentially useful to guide radiotherapy of brain and nasopharynx cancer with standard fractionation.

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“…Although fixed headrest with a head mask is the conventional postural fixation for intracranial tumor radiotherapy, it can shrink and deform over time, thus affecting the positional accuracy of patient treatment. However, personalized custom headrests can avoid this problem and improve radiotherapy accuracy (6). Ghazal Shafai-Erfani et al (7) found systematic errors of 1.1, 2.0, and 2.3 mm in the left-right, head-foot, and anterior-posterior directions, respectively, for the headrest plus mask fixation technique.…”

Section: Introductionmentioning

confidence: 99%

Clinical value of styrofoam fixation in intracranial tumor radiotherapy

Bai

et al. 2023

Front. Oncol.

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ObjectiveTo analyze the application value of two postural fixation techniques.(styrofoam combined with head mask and fixed headrest combined with head mask) in intracranial tumor radiotherapy via cone beam computed tomography (CBCT).MethodsThis study included 104 patients with intracranial tumors undergoing radiotherapy. The patients were divided into two groups: Group A (54 cases with styrofoam fixation) and Group B (50 cases with fixed headrest fixation). The positional deviation in 3D space between the two groups was compared using CBCT. The set-up errors were expressed as median (25th percentile, 75th percentile)or M(p25, p75) since the set-up errors in all directions were not normally distributed,The Mann-Whitney U test was performed.ResultsThe age and gender of patients in the two groups were not significantly different. The set-up errors of A in lateral (X), longitudinal (Y), vertical (Z), and yaw(Rtn) axes were 1.0 (0,1) mm, 1.0 (0,1) mm, 1.0 (0,2) mm, and 0.4 (0.1, 0.8) degrees, respectively while the set-up errors of B were 1.0 (0,1) mm, 1.0 (1,2) mm, 1.0 (0,2) mm, and 0.5 (0.15,0.9) degrees, respectively. Moreover, patients in the styrofoam group had significantly smaller set-up errors in the Y-axis than patients in the headrest group (p=0.001). However, set-up errors in the X, Z, and Rtn axes were not significantly different between the two groups. The expansion boundaries of the target area in the X, Y, and Z directions were 1.77 mm, 2.45 mm, and 2.47 mm, respectively. The outer expansion boundaries of the headrest group were 2.03 mm, 3.88 mm, and 2.57 mm in X, Y, and Z directions, respectively. The set-up times of groups A and B were (32.71 ± 5.21) seconds and (46.57 ± 6.68) seconds, respectively (p=0.014). Patients in group A had significantly better comfort satisfaction than patients in group B (p=0.001).ConclusionStyrofoam plus head thermoplastic mask body fixation technique has a higher positional accuracy in intracranial tumor radiotherapy than headrest plus head thermoplastic mask fixation. Besides, styrofoam plus head thermoplastic mask body fixation technique is associated with improved positioning efficiency, and better comfort than headrest plus head thermoplastic mask fixation, and thus can be effectively applied for intracranial tumor radiotherapy positioning.

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Assessment of set-up errors in the radiotherapy of patients with head and neck cancer: standard vs. individual head support

Abstract: AbstractBackgroundThe aim of the study was to (a) compare the accuracy of two different immobilization strategies for patients with head and neck tumors, and (b) compare the set-up errors on treatment units with different portal imaging systems.Patients and methodsVariati… Show more

Cited by 5 publications

References 8 publications

A retrospective analysis comparing set up errors from standard versus customised headrests for head and neck radiotherapy

A retrospective analysis comparing set up errors from standard versus customised headrests for head and neck radiotherapy

Accuracy of surface‐guided patient setup for conventional radiotherapy of brain and nasopharynx cancer

Clinical value of styrofoam fixation in intracranial tumor radiotherapy

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