体表铅点标记辅助iSCOUT图像引导定位系统在乳腺癌术后调强放疗应用研究

doi:10.3760/cma.j.cn113030-20210317-00111

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Abstract Objective To explore the application value of skin lead marker combined with iSCOUT image-guided positioning system in monitoring and correcting the setup error of intensity-modulated radiotherapy (IMRT) for breast cancer and calculate the PTV margin, aiming to provide reference for clinical practice. Methods 25 breast cancer patients treated with IMRT after modified radical mastectomy in Fujian Medical University Union Hospital from April to August 2019 were enrolled in this study. The skin lead marker combined with iSCOUT image-guided positioning system was employed for image-guided positioning based on the gold standard registration algorithm. Initial setup errors on the x (lateral), y (craniocaudal) and z (anteroposterior) axis and residual errors after the position correction were recorded and analyzed. The effect of the errors before and after image-guided correction upon the plan dose was compared and the reasonable PTV margin was calculated. Results 25 patients received 150 times of positioning verification using skin lead marker combined with iSCOUT image-guided positioning system. The absolute residual errors on the x-, y-and z-axis were (1.53±0.96),(1.30±0.99) and (1.34±0.92)mm, significantly smaller than the initial setup errors of (2.63±2.12),(2.41±2.45) and (3.07±2.77)mm (all P<0.001). The percentage of dose deviation due to residual errors was also smaller than that of the initial errors. Significant differences were observed in D98%, D2%, Dmax of PTV, Dmax of the heart, Dmax of the healthy breast, and Dmean of the affected lung and both lungs. The percentage deviation from the original plan was decreased from 2.18%, 3.19%, 10.66%, 8.75%, 48.21%, 10.50%, and 3.66% to 0.38%, 0.23%, 2.31%, 0.04%, 13.78%, 6.35% and 0.41%, respectively (all P<0.05). PTV margins on the x-, y-and z-axis after correction were calculated as 1.87, 1.75 and 1.69mm, respectively. Conclusion It is feasible and valuable to apply the skin lead marker combined with iSCOUT image-guided positioning system in the positioning verification and correction of breast cancer radiotherapy position, providing novel reference for clinical PTV margin.

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	Articles by authors
	Dong Fangfen
	Dai Liyan
	Huang Miaoyun
	Weng Xing
	Jiang Liuqing
	Xu Benhua
	Li Xiaobo

Key words： Skin lead marker iSCOUT system Breast neoplasm/radiotherapy Setup error Margin

Received: 17 March 2021

Fund:Industry-University-Research Project of Fujian Science and Technology Department (2020Y4010); Fujian Medical University Sailing fund General Project (2020QH1078)

Corresponding Authors: Li Xiaobo, Email:lixiaobo2004@126.com;Xu Benhua, Email:benhuaxu@163.com

Cite this article:

Dong Fangfen,Dai Liyan,Huang Miaoyun et al. Study of setup error and dosimetry of postoperative intensity-modulated radiotherapy for breast cancer using skin lead marker and iSCOUT image-guided positioning system[J]. Chinese Journal of Radiation Oncology, 2021, 30(10): 1059-1064.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20210317-00111 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I10/1059

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