The setup errors of thermoplastic head and shoulder molds with or without vacuum pad in HFSRT for brain metastases in the lung cancer
Li An1, Liu Jia2, Lai Jialu1, Wang Qiang1, Xu Qingfeng1, Zhong Renming1, He Yinbo1, Bai Sen1, Zhou Lin3
1Department of Radiotherapy, State Key Laboratory of Biotherapy, Cancer Center, WestChina Hospital, Sichuan University, Chengdu 610041, China; 2Department of First Oncology, Chengdu First People's Hospital, Chengdu 610016, China; 3Department of Thoracic Oncology, State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
Abstract：Objective To retrospectively analyze the setup errors of thermoplastic head and shoulder molds alone or combined with vacuum pad in hypofractionated stereotactic radiotherapy (HFSRT) for non-small cell lung cancer (NSCLC) with brain metastases. Methods Fifty-four NSCLC patients with brain metastases who received HFSRT from 2017 to 2019 were enrolled in this study. Twenty-four patients were fixed with thermoplastic head and shoulder molds (group A),and 30 patients were fixed with thermoplastic head and shoulder molds plus vacuum pad (group B). The interfraction and intrafraction setup errors were acquired from cone-beam CT online image registration before and after the HFSRT. Optical surface system was applied in monitoring the intrafraction setup errors. The setup errors in each direction between two groups were analyzed by independent samples t-test. Results For the interfraction setup errors of the whole group, the proportion of the horizontal setup errors of ≥3mm was 7.0% to 15.4% and 7.0% to 12.6% for the rotation setup errors of ≥2°. In group A, the anteroposterior setup error was (1.035±1.180)mm, significantly less than (1.512±0.955)mm in group B (P=0.009). In group A, the sagittal rotation setup error was 0.665°±0.582°, significantly less than 0.921°±0.682° in group B (P=0.021). For the intrafraction setup errors of the whole group, the proportion of horizontal setup errors of ≥1mm was 0% to 0.7%, whereas no rotation setup error of ≥1° were observed. In group B, bilateral, anteroposterior and sagittal rotation setup errors were (0.047±0.212)mm,(0.023±0.152)mm and 0.091°±0.090°, significantly less compared with (0.246±0.474)mm,(0.140±0.350)mm and 0.181°±0.210° in group A (P=0.004, P=0.020, P=0.001), respectively. Optical surface monitoring data were consistent with the obtained results. Conclusions Thermoplastic head and shoulder molds (with or without vacuum pad) combined with online image registration and six-dimensional robotic couch correction can be applied in HFSRT for brain metastases from NSCLC. The intrafraction setup errors in group B are smaller than those in group A. Optical surface system has certain value in monitoring the intrafractional movement.
Li An,Liu Jia,Lai Jialu et al. The setup errors of thermoplastic head and shoulder molds with or without vacuum pad in HFSRT for brain metastases in the lung cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(6): 592-597.
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