Intrafraction motion during partial breast irradiation depends on treatment time

Hoekstra, Nienke; Habraken, S.; Swaak-Kragten, Annemarie; Hoogeman, M.; Pignol, Jean-Philippe

doi:10.1016/j.radonc.2021.03.029

Cited by 20 publications

(23 citation statements)

References 40 publications

(55 reference statements)

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“…Ricotti et al [9] also do not observe a correlation between the fraction number and patient drift. Fraction duration however does correlate to baseline drift at the end of the fraction where a longer fraction results in a higher drift, as is observed by Reitz et al [7], Hoekstra et al [10] and Wiant et al [11] for breast cancer patients.…”

Section: Discussionmentioning

confidence: 67%

“…Wiant et al [11] reports stabilization of the patient only after 6-10 min while monitoring free breathing breast cancer patients using surface guidance. In contrast, Hoekstra et al [10] noted no stabilization for Accelerated Partial Breast Irradiation (APBI) treatments where the mean fraction duration was 26 min. On C-arm linacs volumetric image acquisition requires the extension of the kV-source and imager and rotation of the gantry to the correct starting angle.…”

Section: Discussionmentioning

confidence: 98%

“…The magnitude and orientation of baseline drift has been extensively studied for a range of sites such as lung and liver tumors with radiopaque markers [2,3,4,5], breast cancer patients with a laser system [6] or optical surface scanning system [7] and general chest motion using a marker block system [8]. Previous studies have focused on fractions exceeding 20 to 30 min such as lung Stereotactic Body Radiotherapy (SBRT) treatments [3], TomoTherapy deliveries [9] or Accelerated Partial Breast Irradiations (APBI) [10]. Both Ricotti et al [9] and Wiant et al [11] note that breast cancer patients reach a stable position after 6-8 min.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intra-fraction motion monitoring during fast modulated radiotherapy delivery in a closed-bore gantry linac

Delombaerde

Petillion

Weltens

et al. 2021

Physics and Imaging in Radiation Oncology

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intra-fraction motion monitoring during fast modulated radiotherapy delivery in a closed-bore gantry linac

Delombaerde

Petillion

Weltens

et al. 2021

Physics and Imaging in Radiation Oncology

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“…To calculate the single-fraction margins for these two techniques, technique-specific systematic and random errors, expressed as 1 standard deviation of a Gaussian distribution, were taken from literature. For VMAT-APBI, these are beam isocenter accuracy, couch accuracy, and intrafraction motion (Table 1) [25][26][27][28][29]. For CyberKnife-APBI, this is the CyberKnife total system error, which combines imaging and beam adjustment errors.…”

Section: Comprehensive Ctv To Ptv Margin Calculationmentioning

confidence: 99%

Fiducial marker motion relative to the tumor bed has a significant impact on PTV margins in partial breast irradiation

Hoekstra

Habraken

Swaak-Kragten

et al. 2021

Radiotherapy and Oncology

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Introduction: With the introduction of accelerated partial breast irradiation (APBI) and the trend of reducing the number of fractions, the geometric accuracy of treatment delivery becomes critical. APBI patient setup is often based on fiducials, as the seroma is frequently not visible on pretreatment imaging. We assessed the motion of fiducials relative to the tumor bed between planning CT and treatment, and calculated margins to compensate for this motion. Methods: A cohort of seventy patients treated with APBI on a Cyberknife was included. Planning and inroom pretreatment CT scans were registered on the tumor bed. Residual motion of the centers of mass of surgical clips and interstitial gold markers was calculated. We calculated the margins required per desired percentage of patients with 100% CTV coverage, and the systematic and random errors for fiducial motion. Results: For a single fraction treatment, a margin of 1.8 mm would ensure 100% CTV coverage in 90% of patients when using surgical clips for patient set-up. When using interstitial markers, the margin should be 2.2 mm. The systematic and random errors were 0.46 mm for surgical clip motion and 0.60 mm for interstitial marker motion. No clinical factors were found predictive for fiducial motion. Conclusions: Fiducial motion relative to the tumor bed between planning CT and APBI treatment is nonnegligible and should be included in the PTV margin calculation to prevent geographical miss. Systematic and random errors of fiducial motion were combined with other geometric uncertainties to calculate comprehensive PTV margins for different treatment techniques.

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“…They showed that the PTV margin depends on the treatment time. 66 However, poor image quality because of dominant Compton scattering in MV beams remains a major problem in portal imaging. Furthermore, according to the AAPM Task Group 75 report, a significant disadvantage of kV imaging-based motion monitoring is the extra dose to the patient, particularly at the skin surface.…”

Section: Motion Monitoring Techniques In Breast Cancer Rtmentioning

confidence: 99%

Target motion management in breast cancer radiation therapy

Piruzan

Vosoughi

Mahdavi

et al. 2021

Radiology and Oncology

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Background Over the last two decades, breast cancer remains the main cause of cancer deaths in women. To treat this type of cancer, radiation therapy (RT) has proved to be efficient. RT for breast cancer is, however, challenged by intrafractional motion caused by respiration. The problem is more severe for the left-sided breast cancer due to the proximity to the heart as an organ-at-risk. While particle therapy results in superior dose characteristics than conventional RT, due to the physics of particle interactions in the body, particle therapy is more sensitive to target motion. Conclusions This review highlights current and emerging strategies for the management of intrafractional target motion in breast cancer treatment with an emphasis on particle therapy, as a modern RT technique. There are major challenges associated with transferring real-time motion monitoring technologies from photon to particles beams. Surface imaging would be the dominant imaging modality for real-time intrafractional motion monitoring for breast cancer. The magnetic resonance imaging (MRI) guidance and ultra high dose rate (FLASH)-RT seem to be state-of-the-art approaches to deal with 4D RT for breast cancer.

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Intrafraction motion during partial breast irradiation depends on treatment time

Cited by 20 publications

References 40 publications

Intra-fraction motion monitoring during fast modulated radiotherapy delivery in a closed-bore gantry linac

Intra-fraction motion monitoring during fast modulated radiotherapy delivery in a closed-bore gantry linac

Fiducial marker motion relative to the tumor bed has a significant impact on PTV margins in partial breast irradiation

Target motion management in breast cancer radiation therapy

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