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Accuracy of optical surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization
Li Tantan1,2, Liu Qingfeng1, Zhang Tao1,2, Zhang Ye1, Zhang Wei1, Chen Huan1, Li Zhaohui1, Huan Fukui1, Yi Junlin1,2
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 Radiation Oncology, National Cancer Center / National Clinical Research Center for Cancer / Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang 065001, China
AbstractObjective To investigate the feasibility of surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization. Methods Nineteen patients treated with hypo‐ fractionated radiotherapy for intracranial metastasis in our hospital were included. Before the start of treatment, each patient underwent simulation with open face mask immobilization. During the treatment, cone‐beam CT(CBCT)images were collected for verification each time. Laser‐guided positioning was used for the first time in the treatment, and surface images were captured after six‐dimensional position correction as the reference images for subsequent treatment. Subsequent treatment was randomly divided into laser‐guided positioning group(LG, 85/F)and optical surface‐guided positioning group(SG, 101/F). The six‐dimensional error data of patients with two positioning methods were compared and expressed as mean ± standard deviation. Meanwhile, the correlation and consistency between the optical surface error data and the gold standard CBCT error data were compared in the laser‐guided fraction. GraphPad Prism 6.0 software was used for data processing and mapping, and SPSS 21.software was used for mean analysis and normality test. Pearson correlation analysis was used to analyze the correlation, and Bland‐Altman plot analysis was used to test the coincidence between two methods. Results Compared with the laser‐guided positioning, the 3D error of optical surface‐guided positioning was reduced from(0.35±0.16)cm to(0.14±0.07)cm. The Pearson coefficient of correlation along all three directions was less than 0.01,R2 was 0.91,0.70 and 0.78 on Lat, Lng and Vrt, and R2 was 0.75,0.85 and 0.77 on Pitch, Roll and Rtn(all P<0.01), respectively. The measurement results of two methods were positively correlated. The Bland‐Altman plot analysis showed that the 95% limits of agreement were within preset 3 mm tolerance([-0.29 cm, 0.19 cm], [-0.25 cm, 0.25 cm], [-0.27 cm, 0.19 cm]), and the 95% limits of agreement were within preset 3° tolerance(Pitch[-1.76°,1.76°], Roll[-1.54°,1.60°], ROT[-2.18°,1.69°]), indicating agreement between two methods. Conclusions The optical surface‐guided positioning can reduce the setup errors in the hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization. The optical surface error and CBCT error have good correlation and agreement.
Fund:CAMS Innovation Fund for Medical Sciences(2021‐12M‐C&T‐B‐066)
Corresponding Authors:
Yi Junlin, Email: yijunlin1969@163.com
Cite this article:
Li Tantan,Liu Qingfeng,Zhang Tao et al. Accuracy of optical surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization[J]. Chinese Journal of Radiation Oncology, 2022, 31(8): 722-726.
Li Tantan,Liu Qingfeng,Zhang Tao et al. Accuracy of optical surface‐guided hypo‐fractionated radiotherapy for intracranial metastasis with open face mask immobilization[J]. Chinese Journal of Radiation Oncology, 2022, 31(8): 722-726.
[1] Habboush Y, Shannon RP, Niazi SK, et al.Patient‐reported distress and survival among patients receiving definitive radiation therapy[J]. Adv Radiat Oncol, 2017,2(2): 211‐219.DOI: 10.1016/j.adro.2017.03.004.
[2] Nixon JL, Brown B, Pigott AE, et al.A prospective examination of mask anxiety during radiotherapy for head and neck cancer and patient perceptions of management strategies[J]. J Med Radiat Sci, 2019,66(3): 184‐190.DOI: 10.1002/jmrs.346.
[3] Nixon JL, Cartmill B, Turner J, et al.Exploring the prevalence and experience of mask anxiety for the person with head and neck cancer undergoing radiotherapy[J]. J Med Radiat Sci, 2018,65(4): 282‐290.DOI: 10.1002/jmrs.308.
[4] Clover K, Oultram S, Adams C, et al.Disruption to radiation therapy sessions due to anxiety among patients receiving radiation therapy to the head and neck area can be predicted using patient self‐report measures[J]. Psychooncology, 2011,20(12): 1334‐1341.DOI: 10.1002/pon.1854.
[5] Mulla Z, Alwassia RK, Senan EM, et al.A comparative study between open‐face and closed‐face masks for head and neck cancer(HNC)in radiation therapy[J]. Rep Pract Oncol Radiother, 2020,25(3): 382‐388.DOI: 10.1016/j.rpor.2020.03.009.
[6] Wiant D, Squire S, Liu H, et al.A prospective evaluation of open face masks for head and neck radiation therapy[J]. Pract Radiat Oncol, 2016,6(6): e259‐e267.DOI: 10.1016/j.prro.2016.02.003.
[7] Freislederer P, Kügele M, Öllers M, et al.Recent advanced in surface guided radiation therapy[J]. Radiat Oncol, 2020,15(1): 187.DOI: 10.1186/s13014‐020‐01629‐w.
[8] Batista V, Meyer J, Kügele M, et al.Clinical paradigms and challenges in surface guided radiation therapy: Where do we go from here?[J]. Radiother Oncol, 2020,153:34‐42.DOI: 10.1016/j.radonc.2020.09.041.
[9] Covington EL, Fiveash JB, Wu X, et al.Optical surface guidance for submillimeter monitoring of patient position during frameless stereotactic radiotherapy[J]. J Appl Clin Med Phys, 2019,20(6): 91‐98.DOI: 10.1002/acm2.12611.
[10] Tryggestad E, Christian M, Ford E, et al.Inter‐ and intrafraction patient positioning uncertainties for intracranial radiotherapy: a study of four frameless, thermoplastic mask‐based immobilization strategies using daily cone‐beam CT[J]. Int J Radiat Oncol Biol Phys, 2011,80(1): 281‐290.DOI: 10.1016/j.ijrobp.2010.06.022.
[11] Lightstone AW, Tsao M, Baran PS, et al.Cone beam CT(CBCT)evaluation of inter‐ and intra‐fraction motion for patients undergoing brain radiotherapy immobilized using a commercial thermoplastic mask on a robotic couch[J]. Technol Cancer Res Treat, 2012,11(3): 203‐209.DOI: 10.7785/tcrt.2012.500288.
[12] Mancosu P, Fogliata A, Stravato A, et al.Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study[J]. Med Dosim, 2016,41(2): 173‐179.DOI: 10.1016/j.meddos.2015.12.003.
[13] 杜乙,岳海振,王美娇,等.一种基于光学体表监测技术的新型摆位方法在头部放疗中的应用[J]. 中华放射医学与防护杂志,2020,40(3): 209‐215.DOI: 10.3760/cma.j.issn.0254‐5098.2020.03.009.
Du Y, Yue HZ, Wang MJ, et al.Application of a new method for patient positioning based on optical surface monitoring technology to head radiotherapy[J]. Chin J Radiol Med Prot, 2020,40(3): 209‐215.DOI: 10.3760/cma.j.issn.0254‐5098.2020.03.009.
[14] Lee SK, Huang S, Zhang L, et al.Accuracy of surface‐guided patient setup for conventional radiotherapy of brain and nasopharynx cancer[J]. J Appl Clin Med Phys, 2021,22(5): 48‐57.DOI: 10.1002/acm2.13241.
[15] Zhao B, Maquilan G, Jiang S, et al.Minimal mask immobilization with optical surface guidance for head and neck radiotherapy[J]. J Appl Clin Med Phys, 2018,19(1): 17‐24.DOI: 10.1002/acm2.12211.
[16] Kearney M, Coffey M, Leong A.A review of image guided radiation therapy in head and neck cancer from2009‐201 ‐ best practice recommendations for RTTs in the clinic[J]. Tech Innov Patient Support Radiat Oncol, 2020,14:43‐50.DOI: 10.1016/j.tipsro.2020.02.002.
[17] Li G, Lovelock DM, Mechalakos J, et al.Migration from full‐head mask to "open‐face" mask for immobilization of patients with head and neck cancer[J]. J Appl Clin Med Phys, 2013,14(5): 243‐254.DOI: 10.1120/jacmp.v14i5.4400.
[18] Bry V, Licon AL, McCulloch J, et al.Quantifying false positional corrections due to facial motion using SGRT with open‐face masks[J]. J Appl Clin Med Phys, 2021,22(4): 172‐183.DOI: 10.1002/acm2.13170.