Set-Up Errors, Organ Motion, Tumour Regression and its Implications on Internal Target Volume-Planning Target Volume During Cervical Cancer Radiotherapy: Results From a Prospective Study
Set-Up Errors, Organ Motion, Tumour Regression and its Implications on Internal Target Volume-Planning Target Volume During Cervical Cancer Radiotherapy: Results From a Prospective Study
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DOI：
10.1016/j.clon.2021.10.010
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发表时间：
2022-02-07
影响因子：
3.4
通讯作者：
Shrivastava, S.
中科院分区：
文献类型：
--
作者：
Mahantshetty, U.;Naga, P.;Shrivastava, S.
目的：宫颈癌适形放疗期间子宫宫颈运动和器官充盈是复杂的。这项前瞻性观察性研究调查了宫颈癌放疗期间盆腔淋巴结CTV的设置边缘（临床目标vo， me [CTV]到计划目标体积[PTV]）和子宫宫颈运动的内边缘（CTV到内目标体积[ITV]）扩张。材料和方法：在宫颈癌放疗期间，每天进行一次千伏锥束计算机断层扫描（CBCT）。基于骨解剖学的刚性共配准和血管/盆腔结区域的匹配进行，以记录移位，误差（系统和随机）并计算CTV到PTV的边界。随后，在宫颈中区和子宫底进行软组织匹配，记录移位、误差并计算CTV到ITV的边缘。结果：对67例患者1380张CBCT扫描图进行分析。CTV骨盆结区各方向的平均（±标准差）偏移量在4.5 ~ 5.3 mm，系统误差和随机误差在3.0 ~ 3.6 mm，设置边缘在10 mm以内（前边缘10.3 mm除外）。对于颈椎中部区域，平均移位为4.5-5.5 mm，系统和随机误差为2-4 mm
Aims: Uterocervical motions and organ filling during cervical cancer conformal radiotherapy is complex. This prospective, observational study investigated setup margins (clinical target vo, ume [CTV] to planning target volume [PTV]) for pelvic nodal CTV and internal margin (CTV to internal target volume [ITV]) expansions for uterocervical movements during cervical cancer radiotherapy.Materials and methods: During cervical cancer radiotherapy, a daily kilovoltage, cone-beam computed tomography (CBCT) scan was acquired. Bony anatomy based rigid co-registration and matching to vessels/pelvic nodal region was carried out to document shifts, errors (systematic and random) and to calculate CTV to PTV margins. Subsequently, soft-tissue matching was carried out at the mid-cervical region and uterine fundus to record shifts, errors and to calculate CTV to ITV margins.Results: In 67 patients, 1380 CBCT scans were analysed. The mean (+/- standard deviation) couch shifts for CTV pelvic nodal region in all directions were within 4.5-5.3 mm, systematic and random errors 3.0-3.6 mm and set-up margins of within 10 mm (except anterior margin 10.3 mm). For the mid-cervical region, mean shifts were 4.5-5.5 mm, systematic and random errors 2-4 mm amounting to