title: High dose three-dimensional conformal boost (3DCB) using an orthogonal diagnostic X-ray set-up for patients with gynecological malignancy: a new application of real-time tumor-tracking system.
abstract: The feasibility and accuracy of high dose three-dimensional conformal boost (3DCB) using three internal fiducial markers and a two-orthogonal X-ray set-up of the real-time tumor-tracking system on patients with gynecological malignacy were investigated in 10 patients. The standard deviation of the distribution of systematic deviations (Sigma) was reduced from 3.8, 4.6, and 4.9 mm in the manual set-up to 2.3, 2.3 and 2.7 mm in the set-up using the internal markers. The average standard deviation of the distribution of random deviations (sigma) was reduced from 3.7, 5.0, and 4.5 mm in the manual set-up to 3.3, 3.0, and 4.2 mm in the marker set-up. The appropriate PTV margin was estimated to be 10.2, 12.8, and 12.9 mm in the manual set-up and 6.9, 6.7, and 8.3 mm in the gold marker set-up, respectively, using the formula 2Sigma + 0.7sigma. Set-up of the patients with three markers and two fluoroscopy is useful to reduce PTV margin and perform 3DCB.
authors.affiliation: Gynecology, Reproductive and Developmental Medicine, Division of Pathophysiological Science, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-Ku, Sapporo 060-8638, Japan.
authors.forename: Ritsu
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Akio
authors.initials: A
authors.lastname: Yonesaka
authors.forename: Seiko
authors.initials: S
authors.lastname: Nishioka
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Watari
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Daichi
authors.initials: D
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Taguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishioka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Miyasaka
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D019047:Phantoms, Imaging; D011832:Radiation Injuries / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D012494:Sampling Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*