Abstract Objective To investigate the setup errors of super chest segment of esophageal cancer patients before radiotherapy delivery by KV cone beam CT, and evaluate the margin from CTV to PTV. Methods From 2010 to 2012, 13 patients with super chest segment of esophageal cancer whose IMRT planning CT images were included in this study. Delineate target on the CT images of treatment planning and enlarge the margin of CTV to form ITV,then enlarge the margin of ITV gradually 10 times by 1 mm each time to form varied PTV,and create the plan according to the size of the PTV, simulate setup errors in the new plan to obtain the simulation of the actual exposure curve and find a suitable PTV to assure 95% ITV volumeas ever to approach the prescription dose, obtained the outside enlarge distance of CTV→PTV. ResultsThe maximum setup errors in the direction of the anterior and posterior positioning was (3.42±2.19) mm. The margin of ITV→PTV is 5 mm which was figured out by PTV enlarging method. Compared to the original plan that under the condition of draw up the radiotherapy plan that based on the method of PTV enlarging obtained the CTV→PTV and simulate the actual dose distribution according to the setup errors:total lung V5, spinal cord D1cm3 ,increased by about 0.87%, 4.95 Gy, heart V40, PTV D95, PTV V100, ITV D95, ITV V100 were reduced about 0.62%, 4.95 Gy, 8.38%, 1.84 Gy, 1.87%, all of them have statistically difference. Conclusions Range of external expansion of the left to right, superior to inferior and anterior to posterior is 7 mm,8 mm and 7 mm respectively, according to the method of PTV enlarging obtained the margin of CTV→PTV of super chest segment of esophageal cancer patients.
Corresponding Authors:
LIU Ming,Email:lming65@yahoo.com.cn
Cite this article:
ZHANG Yong-xia,ZHAI Fu-shan,LIU Ming et al. The setup errors and reasonable target margin in radiotherapy of superior chest segment esophageal carcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 489-492.
ZHANG Yong-xia,ZHAI Fu-shan,LIU Ming et al. The setup errors and reasonable target margin in radiotherapy of superior chest segment esophageal carcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 489-492.
[1] 曹晓辉,刘明,翟福山,等.用锥形束CT图像引导技术分析肺癌放疗摆位误差及其对剂量分布影响.中华放射肿瘤学杂志,2012,21:163-166. [2] Hashimoto T, Shirato H, Kato M, et al. Real-time monitoring of a digestive tract marker to reduce adverse effects of moving organs at risk (OAR) in radiotherapy for thoracic and abdominal tumors. Int J Radiat Oncol Biol Phys,2005,61:1559-1564. [3] Yamashita H, Kida S, Sakumi A, et al. Four-dimensional measurement of the displacement of internal fiducial markers during 320-multislice computed tomography scanning of thoracic esophageal cancer. Int J Radiat Oncol Biol Phys,2011,79:588-595. [4] Yaremko BP, Guerrero TM, McAleer MF, et al. Determination of respiratory motion for distal esophagus cancer using four-dimensional computed tomography.Int J Radiat Oncol Biol Phys,2008,70:145-153. [5] 程光惠,武宁,韩东梅,等.不同体位固定技术在胸腹部肿瘤放射治疗中的应用比较.中国肿瘤,2010,19:702-704. [6] 李涛,王培,吴大可,等.非小细胞肺癌精确放射治疗呼吸控制及剂量学研究.中国医疗前沿,2007,2:17-19. [7] 杨定宇.放疗技术员的工作职责//胡逸民,杨定宇.肿瘤放射治疗技术.北京:北京医科大学中国协和医科大学联合出版社,1999:14. [8] 许峰,柏森,王瑾,等.用锥形束CT图像测量放疗摆位误差.中华放射肿瘤学杂志,2007,16:461-464. [9] Topolnjak R, Sonke JJ, Nijkamp J, et al. Breast patient setup error assessment:comparison of electronic portal image devices and cone beam computed tomography matching results. Int J Radiat Oncol Biol Phys,2010,78:1235-1243. [10] 林清认,许亚萍,等.IGRT在胸部肿瘤中的应用进展.肿瘤学杂志,2012,18:622-625. [11] 张美玲,叶素贞,陈新佳,等.食管癌患者首次摆位行锥形束CT验证的误差分析.中华肿瘤防治杂志,2012,19:676-678. [12] Van Herk M. Errors and margins in radiotherapy. Semin Radiat Oncol,2004,14:52-64. [13] 肖泽芬.食管癌治疗原则//殷蔚伯,余子豪,徐国镇,等.肿瘤放射治疗学(第4版).北京:中国协和医科大学出版社,2009:546-573. [14] Han C, Wang L, Gao C, et al. The predictive value of low dose volume of lung to acute radiation pneumonitis in thoracic carcinoma treatment using three dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys,2010,78:518-525.