Diaphragm-based position verification to improve daily target dose coverage in proton and photon radiation therapy treatment of distal esophageal cancer
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Autor:innen
Visser, Sabine
den Otter, Lydia A.
Ribeiro, Cássia O.
Korevaar, Erik W.
Both, Stefan
Langendijk, Johannes A.
Muijs, Christina T.
Sijtsema, Nanna M.
Autor:in (Körperschaft)
Publikationsdatum
01.02.2022
Typ der Arbeit
Studiengang
Typ
01A - Beitrag in wissenschaftlicher Zeitschrift
Herausgeber:innen
Herausgeber:in (Körperschaft)
Betreuer:in
Übergeordnetes Werk
International Journal of Radiation. Oncology - Biology – Physics
Themenheft
DOI der Originalpublikation
Link
Reihe / Serie
Reihennummer
Jahrgang / Band
112
Ausgabe / Nummer
2
Seiten / Dauer
463-474
Patentnummer
Verlag / Herausgebende Institution
Elsevier
Verlagsort / Veranstaltungsort
Auflage
Version
Programmiersprache
Abtretungsempfänger:in
Praxispartner:in/Auftraggeber:in
Zusammenfassung
Purpose
In modern conformal radiation therapy of distal esophageal cancer, target coverage can be affected by variations in the diaphragm position. We investigated if daily position verification (PV) extended by a diaphragm position correction would optimize target dose coverage for esophageal cancer treatment.
Methods and Materials
For 15 esophageal cancer patients, intensity modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) plans were computed. Displacements of the target volume were correlated with diaphragm displacements using repeated 4-dimensional computed tomography images to determine the correction needed to account for diaphragm variations. Afterwards, target coverage was evaluated for 3 PV approaches based on: (1) bony anatomy (PV_B), (2) bony anatomy corrected for the diaphragm position (PV_BD) and (3) target volume (PV_T).
Results
The cranial-caudal mean target displacement was congruent with almost half of the diaphragm displacement (y = 0.459x), which was used for the diaphragm correction in PV_BD. Target dose coverage using PV_B was adequate for most patients with diaphragm displacements up till 10 mm (≥94% of the dose in 98% of the volume [D98%]). For larger displacements, the target coverage was better maintained by PV_T and PV_BD. Overall, PV_BD accounted best for target displacements, especially in combination with tissue density variations (D98%: IMPT 94% ± 5%, VMAT 96% ± 5%). Diaphragm displacements of more than 10 mm were observed in 22% of the cases.
Conclusions
PV_B was sufficient to achieve adequate target dose coverage in case of small deviations in diaphragm position. However, large deviations of the diaphragm were best mitigated by PV_BD. To detect the cases where target dose coverage could be compromised due to diaphragm position variations, we recommend monitoring of the diaphragm position before treatment through online imaging.
Schlagwörter
Fachgebiet (DDC)
600 - Technik, Medizin, angewandte Wissenschaften
Veranstaltung
Startdatum der Ausstellung
Enddatum der Ausstellung
Startdatum der Konferenz
Enddatum der Konferenz
Datum der letzten Prüfung
ISBN
ISSN
0360-3016
1879-355X
1879-355X
Sprache
Englisch
Während FHNW Zugehörigkeit erstellt
Nein
Zukunftsfelder FHNW
Publikationsstatus
Veröffentlicht
Begutachtung
Peer-Review der ganzen Publikation
Open Access-Status
Closed
Lizenz
Zitation
VISSER, Sabine, Lydia A. DEN OTTER, Cássia O. RIBEIRO, Erik W. KOREVAAR, Stefan BOTH, Johannes A. LANGENDIJK, Christina T. MUIJS, Nanna M. SIJTSEMA und Antje KNOPF, 2022. Diaphragm-based position verification to improve daily target dose coverage in proton and photon radiation therapy treatment of distal esophageal cancer. International Journal of Radiation. Oncology - Biology – Physics. 1 Februar 2022. Bd. 112, Nr. 2, S. 463–474. DOI 10.1016/j.ijrobp.2021.09.015. Verfügbar unter: https://irf.fhnw.ch/handle/11654/34940