Reproducibility of patient setup in the seated treatment position: A novel treatment chair design
Reproducibility of patient setup in the seated treatment position: A novel treatment chair design
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DOI：
10.1002/acm2.12024
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发表时间：
2017-01-01
影响因子：
2.1
通讯作者：
Court, Laurence E.
中科院分区：
文献类型：
--
作者：
McCarroll, Rachel E.;Beadle, Beth M.;Court, Laurence E.
对于在治疗期间无法躺在治疗床上的患者，在坐姿治疗位置提供上级解剖定位和剂量分布的情况下，或对于使用固定治疗射束和旋转坐姿患者设计的低成本系统，坐姿放射治疗可能适用。在这项研究中，我们报告了一种新型的治疗椅，其构造允许三维成像和治疗，同时确保稳健的固定，提供与传统仰卧位相同的再现性。五名接受头颈部癌症放射治疗的患者被纳入研究，并被安置在椅子上，创建了固定装置，然后在模拟放射治疗的情况下（没有治疗输送）用正交X射线进行成像。所获得的图像的六个子区域严格注册，以评估内部和interfraction位移和椅子的建设。模拟图像制导条件下的位移采集首先注册一个子区域，然后测量其他子区域的残余位移。此外，我们进行了患者问卷调查，以获得患者反馈并评估与仰卧位的比较。平均间和片段内位移的所有分区在坐位分别小于2和3毫米。当模拟图像引导时，L-R和A-P分次间位移平均减少1 mm，提供与仰卧设置相当的质量设置。入组的患者没有坐位治疗的适应症，报告称对坐位或仰卧位没有偏好。新型手术椅设计提供了可接受的分次间和分次内位移，再现性与仰卧位患者报告的再现性相同。患者的反馈将被纳入椅子的改进，促进治疗头颈部癌症的患者谁是不能躺在治疗期间或在一个经济的固定光束设置使用。
Radiotherapy in a seated position may be indicated for patients who are unable to lie on the treatment couch for the duration of treatment, in scenarios where a seated treatment position provides superior anatomical positioning and dose distributions, or for a low-cost system designed using a fixed treatment beam and rotating seated patient. In this study, we report a novel treatment chair that was constructed to allow for three-dimensional imaging and treatment delivery while ensuring robust immobilization, providing reproducibility equivalent to that in the traditional supine position. Five patients undergoing radiation treatment for head-and-neck cancers were enrolled and were setup in the chair, with immobilization devices created, and then imaged with orthogonal X-rays in a scenario that mimicked radiation treatments (without treatment delivery). Six subregions of the acquired images were rigidly registered to evaluate intra- and interfraction displacement and chair construction. Displacements under conditions of simulated image guidance were acquired by first registering one subregion; the residual displacement of other subregions was then measured. Additionally, we administered a patient questionnaire to gain patient feedback and assess comparison to the supine position. Average inter- and intrafraction displacements of all subregions in the seated position were less than 2 and 3 mm, respectively. When image guidance was simulated, L-R and A-P interfraction displacements were reduced by an average of 1 mm, providing setup of comparable quality to supine setups. The enrolled patients, who had no indication for a seated treatment position, reported no preference in the seated or the supine position. The novel chair design provides acceptable inter- and intrafraction displacement, with reproducibility equivalent to that reported for patients in the supine position. Patient feedback will be incorporated in the refinement of the chair, facilitating treatment of head-and-neck cancer in patients who are unable to lie for the duration of treatment or for use in an economical fixed-beam setup.