Comparison of setup errors in supraclavicular regions of lung and esophageal cancer treated with radiotherapy
Wan Bao1, Yang Xu1, Huan Fukui1, Zhang Yanxin1, Feng Xin1, Zhao Yu1, Wu Yingwei1, Geng Songsong1, Men Kuo1, Hui Zhouguang1,2
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2Department of Special Medical Services,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract：Objective To compare the setup errors in the supraclavicular regions of two different postures (arms placed on each side of the body, namely the body side group;arms crossed and elbows placed above forehead, namely the uplifted group) using the chest and abdomen flat frame fixation device in lung and esophageal cancer. Methods Clinical data of patients with stage Ⅰ to Ⅳ lung or esophageal cancer who received three-dimensional radiotherapy with chest and abdomen flat frame fixation device in our institution from November 2020 to April 2021 were retrospectively analyzed. The setup errors of two postures were compared. Results A total of 56 patients were included, including 31 patients (55%) in the body side group and 25 patients (45%) in the uplifted group. A total of 424 CBCTs were performed in the whole group. The overall setup errors in the X, Y and Z directions were similar in both groups (P>0.05). The setup errors of sternoclavicular joint in the X and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.163±0.120) cm vs. (0.209 ±0.152) cm, P=0.033;0.715°±0.628° vs. 0.910°±0.753°,P=0.011]. The setup errors of acromioclavicular joint in the Y,Z and RZ directions in the body side group were significantly smaller than those in the uplifted group [(0.233±0.135) cm vs. (0.284±0.193) cm, P=0.033;(0.202±0.140) cm vs. (0.252±0.173) cm, P=0.005;0.671°±0.639° vs. 0.885°±0.822°,P=0.023]. The margins of target volume for setup errors were smaller in the X (0.45cm vs. 0.54cm) and Y (0.54cm vs. 0.65cm) directions of the sternoclavicular joint, as well as in the Y (0.59cm vs. 0.78cm) and Z directions (0.53cm vs. 0.72cm) of the acromioclavicular joint in the body side group. Conclusions For lung and esophageal cancer patients requiring supraclavicular irradiation, the body side group yields smaller setup errors and corresponding margins of target volume than the uplifted group. In clinical practice, it is necessary to take comprehensive consideration of the accuracy of radiotherapy and additional radiation of the limbs to select appropriate posture.
Wan Bao,Yang Xu,Huan Fukui et al. Comparison of setup errors in supraclavicular regions of lung and esophageal cancer treated with radiotherapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(3): 272-271.
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