Impact of body-mass factors on setup displacement in patients with head and neck cancer treated with radiotherapy using daily on-line image guidanceReportar como inadecuado




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Radiation Oncology

, 9:19

Clinical Radiation Oncology

Abstract

BackgroundTo determine the impact of body-mass factors BMF before radiotherapy and changes during radiotherapy on the magnitude of setup displacement in patients with head and neck cancer HNC.

MethodsThe clinical data of 30 patients with HNC was analyzed using the alignment data from daily on-line on-board imaging from image-guided radiotherapy. BMFs included body weight, body height, and the circumference and bilateral thickness of the neck. Changes in the BMFs during treatment were retrieved from cone beam computed tomography at the 10th and 20th fractions. Setup errors for each patient were assessed by systematic error SE and random error RE through the superior-inferior SI, anterior-posterior AP, and medial-lateral ML directions, and couch rotation CR. Using the median values of the BMFs as a cutoff, the impact of the factors on the magnitude of displacement was assessed by the Mann–Whitney U test.

ResultsA higher body weight before radiotherapy correlated with a greater AP-SE p = 0.045, SI-RE p = 0.023, and CR-SE p = 0.033. A longer body height was associated with a greater SI-RE p = 0.002. A performance status score of 1 or 2 was related to a greater AP-SE p = 0.043, AP-RE p = 0.015, and SI-RE p = 0.043. Among the ratios of the BMFs during radiotherapy, the values at the level of mastoid tip at the 20 fraction were associated with greater setup errors.

ConclusionsTo reduce setup errors in patients with HNC receiving RT, the use of on-line image-guided radiotherapy is recommended for patients with a large body weight or height, and a performance status score of 1–2. In addition, adaptive planning should be considered for those who have a large reduction ratio in the circumference <1 and thickness <0.94 over the level of the mastoid tip during the 20 fraction of treatment.

KeywordsAdaptive radiotherapy Body-related factors Head and neck cancer Image-guided radiotherapy Setup error Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-9-19 contains supplementary material, which is available to authorized users.

Yo-Liang Lai, Chun-Yen Yu contributed equally to this work.

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Autor: Yo-Liang Lai - Shih-Neng Yang - Ji-An Liang - Yao-Ching Wang - Chun-Yen Yu - Ching-Hsiung Su - Shang-Wen Chen

Fuente: https://link.springer.com/



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