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11/11/2018 Evaluation of localization errors for craniospinal axis irradiation delivery using volume modulated arc therapy and

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Pamela Myers, Sotirios Stathakis , Panayiotis Mavroidis, Carlos Esquivel, Niko Papanikolaou
Department of Radiation Oncology, School of Medicine Cancer Therapy & Research Center, The University of Texas Export Citation
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Dosimetry auditing Evaluation of the clinical
procedure with alanine usefulness for using
DOI: https://doi.org/10.1016/j.radonc.2013.05.026 | Order Reprints
dosimeters for light ion (100 minimum order)verification images during
beam therapy frameless radiosurgery
Ableitinger, Alexander et al. Gevaert, Thierry et al.
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Abstract
Optimizing clinical research and
Purpose generating prospective high-
To dosimetrically evaluate the effects of improper patient positioning in the junction area of a VMAT cranio-spinal
axis irradiation technique consisting of one superior and one inferior arc and propose a solution to minimize these quality data in particle therapy in
patient setup errors. Europe: Introducing the European
Particle Therapy Network (EPTN)
Methods
Cai Grau, Michael Baumann, Damien Charles
Five (n = 5) cranio-spinal axis irradiation patients were planned with 2 arcs: one superior and one inferior. In order
Weber
to mimic patient setup errors, the plans were recalculated with the inferior isocenter shifted by: 1, 2, 5, and 10 mm
superiorly, and 1, 2, 5, and 10 mm inferiorly. The plans were then compared with the corresponding original, non-
shifted arc plans on the grounds of target metrics such as conformity number and homogeneity index, as well as
Greater reduction in mid-
several normal tissue dose descriptors. “Gradient-optimized” plans were then created for each patient in an effort
to reduce dose discrepancies due to setup errors.
treatment FDG-PET volume may
be associated with worse survival
Results in non-small cell lung cancer
Percent differences were calculated in order to compare each of the eight shifted plans with the original non-
Feng-Ming (Spring) Kong, Ling Li, Weili Wang,
shifted arc plan, which corresponds to the ideal patient setup. The conformity number was on average lower by
Jeff Campbell, Jennifer L. Waller, Morand
0.9%, 2.7%, 5.8%, and 9.1% for the 1, 2, 5, and 10 mm inferiorly-shifted plans and 0.4%, 0.8%, 2.8%, and 6.0%
Piert, and others
for the respective superiorly-shifted plans. The homogeneity indices were, averaged among the five patients and
they indicated less homogeneous dose distributions by 0.03%, 0.3%, 1.0%, and 2.8% for the inferior shifts and
0.2%, 1.2%, 6.3%, and 15.3% for the superior shifts. Overall, the mean doses to the organs at risk deviate by Practice patterns of image guided
less than 2% for the 1, 2, and 5 mm shifted plans. The 10 mm shifted plans, however, showed average percent
differences, over all studied organs, from the original plan of up to 5.6%. Using “gradient-optimized” plans, the
particle therapy in Europe: A 2016
average dose differences were reduced by 0.2%, 0.5%, 1.2%, and 2.1% for 1, 2, 5, and 10 mm shifts, survey of the European Particle
respectively compared to the originally optimized plans, and the maximum dose differences were reduced by Therapy Network (EPTN)
11.7%, 8.5%, 12.4%, and 13.9% on average for the 1, 2, 5, and 10 mm shifted plans.

https://www.thegreenjournal.com/article/S0167-8140(13)00246-6/pdf 1/2
11/11/2018 Evaluation of localization errors for craniospinal axis irradiation delivery using volume modulated arc therapy and proposal of a techniqu…

Conclusions Alessandra Bolsi, Marta Peroni, Dante Amelio,


Setup errors related to isocenter shifting should be minimized in order to provide the patient with the most Alexandru Dasu, Markus Stock, Iuliana Toma-
dosimetrically accurate treatment possible. Errors of 1–2 mm can negatively affect the quality of the delivered Dasu, and others
treatment, most notably in the arc junction area, but the deterioration of the treatment plan accuracy is not as
problematic as in the cases of larger errors such as 5–10 mm. By employing a new planning technique, the dose
differences due to setup errors can be greatly reduced.
Letter to the Editor of
Radiotherapy and Oncology
regarding the paper entitled
Keywords: “Prospective Data Registration
Craniospinal axis irradiation, VMAT, Setup errors and Clinical Trials for Particle
Therapy” by Langendijk et al.
Anne Laprie, Valérie Bernier, Christian Carrie
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Dosimetry auditing Evaluation of the clinical


procedure with alanine
© 2013 Elsevier
When choosing
usefulness first-line
for using
dosimeters for lightIreland
ion Ltd. Published by Elsevier Inc. All rights reserved. verification images during
beam therapy treatment for EGFR
frameless M+
radiosurgery
Ableitinger, Alexander et al. NSCLC howGevaert,
influential
Thierry et al.is

the chance to extend


chemotherapy-free time?

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us what you think

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