Analysis of interfractional set-up errors and intrafractional organ motions during IMRT for head and neck tumors to define an appropriate planning target volume (PTV)- and planning organs at risk volume (PRV)-margins.
OBJECTIVE
To analyze the interfractional set-up errors and intrafractional organ motions and to define appropriate planning target volume (PTV)- and planning organs at risk volume (PRV)-margins in intensity-modulated radiotherapy (IMRT) for head and neck tumors.


METHODS
Twenty-two patients with head and neck or brain tumors who were treated with IMRT were enrolled. The set-up errors were defined as the displacements of the coordinates of bony landmarks on the beam films from those on the simulation films. The organ motions were determined as the displacements of the coordinates of the landmarks on the images recorded every 3 min for 15 min on the X-ray simulator from those on the initial image.


RESULTS
The standard deviations (SDs) of the systematic set-up errors (Sigma-INTER) and organ motions (Sigma-intra) distributed with a range of 0.7-1.3 and 0.2-0.8 mm, respectively. The average of the SDs of the random set-up errors (sigma-INTER) and organ motions (sigma-intra) ranged from 0.7 to 1.6 mm and from 0.3 to 0.6 mm, respectively. Appropriate PTV-margins and PRV-margins for all the landmarks ranged from 2.0 to 3.6 mm and from 1.8 to 2.4 mm, respectively.


CONCLUSIONS
We have adopted a PTV-margin of 5mm and a PRV-margin of 3mm for head and neck IMRT at our department.
Suzuki
Minoru
M
Department of Radiation Oncology, Kinki University School of Medicine, Osaka, Japan. msuzuki@rri.kyoto-u.ac.jp
Nishimura
Yasumasa
Y
Nakamatsu
Kiyoshi
K
Okumura
Masahiko
M
Hashiba
Hisayuki
H
Koike
Ryuta
R
Kanamori
Shuichi
S
Shibata
Toru
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001822:Body Burden; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods*; D012062:Relative Biological Effectiveness; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome