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Study of setup error in cone beam CT for whole breast intensity-modulated radiotherapy with breast board immobilization
Yu Shufei1,2, Wang Shulian1, Tang Yu1, Song Yongwen1, Chen Siye1, Li Minghui1, Jin Jing1, Liu Yueping1, Fang Hui1, Chen Bo1, Qi Shunan1, Li Ning1, Tang Yuan1, Lu Ningning1, Li Yexiong1
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences ( CAMS ) and Peking Union Medical College ( PUMC),Beijing 100021,China; 2Department of Oncology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China
AbstractObjective To investigate the setup errors and influencing factors of the whole breast intensity-modulated radiotherapy (IMRT) after breast-conserving surgery, and to identify the margins from clinical target volume (CTV) to planning target volume (PTV). Methods Thirty patients with left-sided (n=15) or right-sided breast cancer (n=15) receiving whole breast hypofractionated IMRT with breast board immobilization after breast-conserving surgery in Cancer Hospital from 2016 to 2017 were enrolled. The kilo-voltage cone-beam computed tomography (CBCT) was used to compare the errors of planning CT and treatment unit and determine the setup errors. The margins from CTV to PTV were calculated. The setup errors under different conditions were statistically compared by t-test. Results A total of 151 sets of CBCT images were taken in the whole cohort,(5.0±1.3) sets per patient on average. The setup errors in the x-axis (left-right direction), y-axis (cranial-caudal direction) and z-axis (anterior-posterior direction) were (2.2±1.7) mm,(3.1±2.5) mm and (3.3±2.3) mm, respectively. The margins from CTV to PTV were 6.39 mm, 10.00 mm and 8.57 mm, respectively. The setup error in anterior-posterior direction in the first week was (3.7±2.5) mm, significantly larger than (2.6±1.6) mm in the following week (P=0.002). The setup error of the patients with overweight or obesity was (3.9±2.6) mm, significantly higher than (2.9±2.0) mm in those with normal weight in the z-axis direction (P=0.033). Conclusion The margins from CTV to PTV are recommended to be ranged from 6 to 10 mm during hypofractionated whole breast IMRT with breast board immobilization after breast-conserving surgery. More frequent imaging verification should be applied in the first week of IMRT.
Yu Shufei,Wang Shulian,Tang Yu et al. Study of setup error in cone beam CT for whole breast intensity-modulated radiotherapy with breast board immobilization[J]. Chinese Journal of Radiation Oncology, 2019, 28(7): 532-535.
Yu Shufei,Wang Shulian,Tang Yu et al. Study of setup error in cone beam CT for whole breast intensity-modulated radiotherapy with breast board immobilization[J]. Chinese Journal of Radiation Oncology, 2019, 28(7): 532-535.
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2019, Vol. 28 
