Dosimetric and Radiobiological Impact of Patient Setup Errors in Intensity-modulated Radiotherapy for Esophageal Cancer.

IF 2.7 4区医学 Q3 ONCOLOGY Technology in Cancer Research & Treatment Pub Date : 2025-01-01 DOI:10.1177/15330338241311136

Jia-Huan Cai, Xun Peng, Jia-Yang Lu

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Abstract

Purpose: To evaluate the impact of patient setup errors on the dosimetry and radiobiological models of intensity-modulated radiotherapy (IMRT) for esophageal cancer.

Methods and materials: This retrospective study with 56 patients in thermoplastic mask (TM) and vacuum bag (VB) groups utilized real setup-error (RSE) data from cone-beam CT scans to generate simulated setup-error (SSE) data following a normal distribution. The SSE data were applied to simulate all treatment fractions per patient by shifting the plan isocenter and recalculating the dose. A simulated plan sum (SPS) was created by accumulating all simulated fraction plans. Comparisons of target dose, improved homogeneity index (iHI), conformity index (CI), tumor control probability (TCP) and normal tissue complication probability (NTCP) were conducted between SPSs and original treatment plans (OTPs). Correlations between RSE and TCP/NTCP were analyzed.

Results: Compared to OTPs in the TM group, the planning target volume (PTV) of SPSs showed reductions in D_95%, D_98%, iHI, CI and TCP by 1.2%, 2.2%, 2.3%, 7.3% and 1.2%, while D_2% increased by 0.3%; D_2% of clinical target volume (CTV) increased by 0.2% (P < .05). In the VB group, D_95%, D_98%, iHI, CI and TCP of PTV decreased by 2.5%, 4.5%, 4.2%, 15.6% and 2.0%, with D_2% increasing by 0.5%; D_2% of CTV increased by 0.5% while D_98% decreased by 0.2% (P < .05). The dose of organs at risk (OARs) changed slightly in both groups. The mean and standard deviation of absolute RSE negatively correlated with the TCP of PTV, while the mean RSE positively correlated with the NTCP of lung and spinal cord.

Conclusions: Setup errors may reduce dose homogeneity and conformity, potentially reducing TCP of PTV and increasing NTCP, especially when mean RSE shifts the isocenter towards OARs. VB immobilization may result in relatively larger impacts of setup errors, but this needs future validation.

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食管癌调强放疗中患者设置错误对剂量学和放射生物学的影响。

目的：评价患者设置错误对食管癌调强放疗剂量学和放射生物学模型的影响。方法和材料：本回顾性研究采用热塑性口罩（TM）组和真空袋（VB）组56例患者，利用锥束CT扫描的真实设置误差（RSE）数据生成符合正态分布的模拟设置误差（SSE）数据。SSE数据通过移动计划等中心和重新计算剂量来模拟每个患者的所有治疗分数。将所有模拟分数方案累加形成模拟方案和（SPS）。比较SPSs与原治疗方案（OTPs）的靶剂量、改善均匀性指数（iHI）、符合性指数（CI）、肿瘤控制概率（TCP）和正常组织并发症概率（NTCP）。分析RSE与TCP/NTCP的相关性。结果：与TM组相比，sp的计划靶体积（PTV） D95%、D98%、iHI、CI和TCP分别降低1.2%、2.2%、2.3%、7.3%和1.2%，D2%升高0.3%；临床靶体积（CTV）的D2%升高0.2% (P分别为95%、98%，PTV的iHI、CI、TCP分别降低2.5%、4.5%、4.2%、15.6%、2.0%，D2%升高0.5%；结论：设置误差可能降低剂量均匀性和一致性，可能降低PTV的TCP并增加NTCP，特别是当平均RSE使等中心向OARs移动时。VB固定可能会导致相对较大的设置错误影响，但这需要进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Technology in Cancer Research & Treatment 医学-肿瘤学

CiteScore

4.40

自引率

0.00%

发文量

202

审稿时长

2 months

期刊介绍： Technology in Cancer Research & Treatment (TCRT) is a JCR-ranked, broad-spectrum, open access, peer-reviewed publication whose aim is to provide researchers and clinicians with a platform to share and discuss developments in the prevention, diagnosis, treatment, and monitoring of cancer.