title: Uncertainties and CTV to PTV margins quantitative assessment using cone-beam CT technique in clinical application for prostate, and head and neck irradiation tumours.
abstract: PURPOSE To evaluate the magnitude of systematic and random errors from a subset of 100 prostate and 26 head and neck (H&N) cancer patients treated with conventional conformal radiotherapy and using image-guided radiotherapy (IGRT). After treatment, the uncertainties involved and the CTV to PTV margin were evaluated. MATERIAL AND METHODS An Elekta Synergy® linear accelerator was used, taking advantage of 3D on-board computed tomography. IGRT with no-action level (NAL) protocol was applied, reporting the 3D translation and rotation corrections. A statistical study was performed to analyse systematic, random and interobserver uncertainties, and, finally, to obtain the CTV to PTV margins. RESULTS The H&N patients' uncertainties found were smaller than those of prostate patients. The CTV to PTV margins assessed, following the guidelines found in the literature, in the three dimensions of space (right-left, superior-inferior, anterior-posterior) were (5.3, 3.5, 3.2) mm for H&N and (7.3, 7.0, 9.0) mm for prostate cancer treatments. CONCLUSIONS It was found that assessing all the involved uncertainties within radiation treatments was very revealing; their quality improves using IGRT techniques and performing extensive data analysis.
authors.affiliation: Medical Physics Department, Instituto Oncológico, Consorcio Hospitalario Provincial de Castelló, Castellón de la Plana, Spain.
authors.forename: X J
authors.initials: XJ
authors.lastname: Juan-Senabre
authors.forename: J
authors.initials: J
authors.lastname: López-Tarjuelo
authors.forename: A
authors.initials: A
authors.lastname: Conde-Moreno
authors.forename: A
authors.initials: A
authors.lastname: Santos-Serra
authors.forename: A L
authors.initials: AL
authors.lastname: Sánchez-Iglesias
authors.forename: J D
authors.initials: JD
authors.lastname: Quirós-Higueras
authors.forename: N
authors.initials: N
authors.lastname: de Marco Blancas
authors.forename: S
authors.initials: S
authors.lastname: Calzada-Feliu
authors.forename: C
authors.initials: C
authors.lastname: Ferrer-Albiach
mesh_terms: D054893:Cone-Beam Computed Tomography; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D010315:Particle Accelerators; D011467:Prostate / Q000000981:diagnostic imaging*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D020266:Radiotherapy, Conformal; D061089:Radiotherapy, Image-Guided / Q000379:methods; D035501:Uncertainty
references.citation: Int J Radiat Oncol Biol Phys. 1998 Dec 1;42(5):1155-61
references.pmid: 9869243
references.citation: Semin Radiat Oncol. 2005 Jul;15(3):168-79
references.pmid: 15983942
references.citation: Radiother Oncol. 1994 May;31(2):161-8
references.pmid: 8066195
references.citation: Int J Radiat Oncol Biol Phys. 2005 Mar 15;61(4):969-83
references.pmid: 15752876
references.citation: Med Phys. 2007 Oct;34(10):4041-63
references.pmid: 17985650
references.citation: Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):75-82
references.pmid: 17869445
references.citation: Int J Radiat Oncol Biol Phys. 2006 Jun 1;65(2):548-53
references.pmid: 16545919
references.citation: Int J Radiat Oncol Biol Phys. 2008 Nov 1;72(3):949-56
references.pmid: 19014783
references.citation: Int J Radiat Oncol Biol Phys. 1998 Mar 1;40(4):967-76
references.pmid: 9531383
references.citation: Int J Radiat Oncol Biol Phys. 2001 Mar 1;49(3):869-84
references.pmid: 11172971
references.citation: Radiother Oncol. 1992 May;24(1):45-54
references.pmid: 1620887
references.citation: Int J Radiat Oncol Biol Phys. 2000 Jan 15;46(2):499-506
references.pmid: 10661359
references.citation: Radiother Oncol. 2002 Jul;64(1):75-83
references.pmid: 12208578
references.citation: Radiother Oncol. 2007 Nov;85(2):201-6
references.pmid: 17904671
references.citation: Clin Transl Oncol. 2009 Apr;11(4):253-6
references.pmid: 19380304
references.citation: Clin Transl Oncol. 2009 Sep;11(9):615-21
references.pmid: 19776002
references.citation: Int J Radiat Oncol Biol Phys. 2008 Jan 1;70(1):289-95
references.pmid: 17919837
references.citation: Med Phys. 2002 Sep;29(9):1998-2012
references.pmid: 12349921
references.citation: Radiother Oncol. 2001 Feb;58(2):105-20
references.pmid: 11166861
references.citation: Int J Radiat Oncol Biol Phys. 2000 Jun 1;47(3):825-39
references.pmid: 10837971
references.citation: Int J Radiat Oncol Biol Phys. 2001 Aug 1;50(5):1350-65
references.pmid: 11483348
references.citation: Med Phys. 2007 May;34(5):1789-96
references.pmid: 17555260
references.citation: Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1416-25
references.pmid: 18439767
references.citation: Radiother Oncol. 2007 Jan;82(1):38-45
references.pmid: 17141903
references.citation: Int J Radiat Oncol Biol Phys. 2000 Jul 1;47(4):1121-35
references.pmid: 10863086
references.citation: J Appl Clin Med Phys. 2006 Apr 12;8(1):55-68
references.pmid: 17592448
references.citation: Int J Radiat Oncol Biol Phys. 1992;22(1):159-65
references.pmid: 1727113
references.citation: Clin Transl Oncol. 2009 Aug;11(8):511-7
references.pmid: 19661025