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KMID : 1164220140260020247
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Journal of Korean Society for Radiotherapeutic Technology
2014 Volume.26 No. 2 p.247 ~ p.256
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Analysis of inter-fraction and intra-fraction errors during volumetric modulated arc therapy in Pancreas Ca
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Jo Young-Pil
Seo Dong-Rin
Hong Tack-Kyun
Kang Tae-Young
Back Geum-Mun
Hong Dong-Ki
Yoon In-Ha
Kim Jin-San
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Abstract
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Purpose : To assess target motion during radiotherapy by quantifying daily setup errors and inter-fractional and intra-fractional movements of pancreatic fiducials.
Materials and Methods : Eleven patients were treated via stereotactic body radiotherapy (SBRT) with volumetric modulated arc therapy. Bony setup errors were calculated using cone beam computed tomography (CBCT). Inter-fractional and intrafractional fiducial (seed) motion was determined via cone beam computed tomography (CBCT) projections and orthogonal fluoroscopy.
Results : Using an off-line correction protocol, setup errors were 0.0 (-1.7-4.0), 0.3 (-0.5-3.0), and 0.0 (-4.1-6.6) mm for the left-right, anterior-posterior, and superior-inferior directions respectively. Random inter-fractional setup errors in the mean fiducial positions were -0.1, -1.1, and -2.3 mm respectively. Intra-fractional fiducial margins were 9.9, 7.8, and 12.5 mm, respectively.
Conclusion : Online inter-fractional and intra-fractional corrections based on daily kV images and CBCT expedites SBRT of pancreatic cancer. Importantly, inter-fractional and intra-fractional motion needs to be measured regularly during treatment of pancreatic cancer to account for variations in patient respiration.
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KEYWORD
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Cone beam computed tomography (CBCT), Inter-fraction, Intra-fraction, Fiducial Marker, volumetric-modulated arc therapy (V-MAT)
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