Analysis of different fixation devices in precision radiotherapy for prostate cancer under bowel and bladder preparation protocol
Huang Sijuan1, Zhong Ziyue1,2, Tang Hao3, Liu Yang1, He Mengxue1, Guo Xuan1, He Liru1, Lin Zhiyue1, Yao Wenyan1, Xu Senkui1, Yang Xin1
1Sun Yat‐sen University Cancer Center / State Key Laboratory of Oncology in South China / Collaborative Innovation Center for Cancer Medicine / Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou 510060, China; 2Guangzhou XinHua College, Guangzhou 510520, China; 3Guangdong Provincial Traditional Chinese and Western Medicine Hospital, Foshan 528200, China
Abstract：Objective To provide evidence for the selection of fixation devices and CTV to PTV margins (Mptv) in precision radiotherapy for pelvic tumors by analyzing three fixation devices in precision radiotherapy for prostate cancer. Methods From April 2015 to December 2020, 133 prostate cancer patients treated with pelvic drainage area irradiation in our center were retrospectively analyzed. The patients were fixed with 1.2m vacuum bag (n=39), 1.8m vacuum bag (n=44) and personalized prone plate by our center (n=50). Each patient was asked to complete our bowel and bladder preparation process before positioning and radiotherapy. The registration of CBCT to planned CT before each treatment adopted the same registration box and algorithm. Setup errors in the SI, LR and AP directions under qualified bowel and bladder conditions were recorded. Setup errors in three directions under three fixation devices and corresponding Mptv values were analyzed. The correlation between setup errors with age and body mass index (BMI) was analyzed. Results Analysis of 3333 setup errors data showed: in the SI and LR directions, the mean setup errors of 1.2m vacuum bag (3.26mm, 2.34mm) were greater than those of 1.8m vacuum bag (2.51mm, P<0.001; 1.90mm, P<0.001), and personalized prone plate (3.07mm, P=0.066; 2.10 mm, P=0.009). In the AP direction, the mean setup errors of 1.2m vacuum bag (supine)(2.20mm) were smaller than those of 1.8m vacuum bag (3.33mm, P<0.001) and personalized prone plate (3.61mm, P<0.001). The setup errors of 1.8m vacuum bag in all directions were smaller than those of personalized prone plate (P≤0.028). According to Van Herk's expansion formula, the Mptv of 1.2m vacuum bag in three directions was approximately 4 mm. The Mptv of 1.8m vacuum bag and personalized prone plate in the SI and LR directions was approximately 3 mm, and more than 5 mm in the AP direction. The setup errors were not correlated with age or BMI. Conclusions From the setup errors results of three devices, 1.8m vacuum bag is the best, followed by personalized prone plate. And supine position is better than prone position in the AP direction.
Huang Sijuan,Zhong Ziyue,Tang Hao et al. Analysis of different fixation devices in precision radiotherapy for prostate cancer under bowel and bladder preparation protocol[J]. Chinese Journal of Radiation Oncology, 2022, 31(8): 716-721.
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