Evaluation of image-guided and surface-guided radiotherapy for breast cancer patients treated in deep inspiration breath-hold: A single institution experience.
Evaluation of image-guided and surface-guided radiotherapy for breast cancer patients treated in deep inspiration breath-hold: A single institution experience.
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DOI：
10.1016/j.tipsro.2022.02.001
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发表时间：
2022-03
影响因子：
--
通讯作者：
Dirkx M
中科院分区：
文献类型：
--
作者：
Penninkhof J;Fremeijer K;Offereins-van Harten K;van Wanrooij C;Quint S;Kunnen B;Hoffmans-Holtzer N;Swaak A;Baaijens M;Dirkx M
SGRT 提供对患者体位和 DIBH 的连续无创监测。定位和 DIBH 的变化需要每日在线设置修正。使用 SGRT 的设置比基于激光的设置稍快，但精度相似。给患者的视觉反馈增强了 DIBH 依从性和可重复性。如今，深吸气屏气是左乳放疗中减少心脏剂量的常用技术。这项研究评估了我们研究所屏气技术的演变，从剂量输送过程中的射野成像到表面引导放射治疗 (SGRT) 的连续监测。分析了 2014 年之前治疗的 98 名患者的设置数据和射野成像结果，以及 2018 年至 2020 年间治疗的 228 名患者的 SGRT 数据。对于 SGRT 前组，计算了不同校正方案的系统和随机设置误差。对两组的残余误差和屏气的再现性进行了评估。对另一组 47 名患者使用 SGRT 进行初始定位的益处进行了评估。在线校正将总体平均误差从 3.9 毫米（无校正）减少到 1.4 毫米。尽管进行了在线设置校正，但在腹背侧和头尾方向的治疗光束中，分别观察到约 10% 和 20% 的偏差大于 3 毫米。然而，这些百分比比离线协议或没有修正的要小得多。 SGRT 组中屏气之间的平均绝对差异 (1.69 mm) 小于 SGRT 前组 (2.10 mm)，并且通过添加视觉反馈进一步改善 (1.30 mm)。用于定位的 SGRT 并没有提高设置精度，但稍微减少了成像和设置校正的时间，允许在 3.5 分钟内完成 95% 的分数。为了使用深吸气屏气进行精确的放射治疗，需要每天进行成像和校正。 SGRT 提供治疗期间患者定位的准确信息，并提高患者对视觉反馈的依从性。
SGRT provides continuous non-invasive monitoring of patient’s positioning and DIBH. Variation in positioning and DIBH requires daily online setup corrections. Setup using SGRT is slightly faster than laser-based setup, with similar accuracy. Visual feedback to the patient enhances DIBH compliance and reproducibility. Nowadays, deep inspiratory breath-hold is a common technique to reduce heart dose in left-sided breast radiotherapy. This study evaluates the evolution of the breath-hold technique in our institute, from portal imaging during dose delivery to continuous monitoring with surface-guided radiotherapy (SGRT). Setup data and portal imaging results were analyzed for 98 patients treated before 2014, and SGRT data for 228 patients treated between 2018 and 2020. For the pre-SGRT group, systematic and random setup errors were calculated for different correction protocols. Residual errors and reproducibility of breath-holds were evaluated for both groups. The benefit of using SGRT for initial positioning was evaluated for another cohort of 47 patients. Online correction reduced the population mean error from 3.9 mm (no corrections) to 1.4 mm. Despite online setup correction, deviations greater than 3 mm were observed in about 10% and 20% of the treatment beams in ventral-dorsal and cranial-caudal directions, respectively. However, these percentages were much smaller than with offline protocols or no corrections. Mean absolute differences between breath-holds within a fraction were smaller in the SGRT-group (1.69 mm) than in the pre-SGRT-group (2.10 mm), and further improved with addition of visual feedback (1.30 mm). SGRT for positioning did not improve setup accuracy, but slightly reduced the time for imaging and setup correction, allowing completion within 3.5 min for 95% of fractions. For accurate radiotherapy breast treatments using deep inspiration breath-hold, daily imaging and correction is required. SGRT provides accurate information on patient positioning during treatment and improves patient compliance with visual feedback.
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影响因子：
4
作者：
Lai, Junming;Hu, Shuang;Long, Xin
通讯作者：
Long, Xin
影响因子：
2.6
作者：
Colgan, Ruth;James, Matthew;Donovan, Ellen M.
通讯作者：
Donovan, Ellen M.
影响因子：
5.7
作者：
de Boer, Hans C. J.;van den Bongard, Desiree J. G.;van Asselen, Bram
通讯作者：
van Asselen, Bram
影响因子：
2.1
作者：
Smyth, Lloyd M;Knight, Kellie A;Aarons, Yolanda K;Wasiak, Jason
通讯作者：
Wasiak, Jason
影响因子：
2.1
作者：
Fassi, Aurora;Ivaldi, Giovanni B.;Baroni, Guido
通讯作者：
Baroni, Guido