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Analysis of inter-fraction and intra-fraction errors during volumetric modulated arc therapy in Pancreas Ca  

Jo, Young Pil (Department of Radiation Oncology, Asan Medical Center)
Seo, Dong Rin (Department of Radiation Oncology, Asan Medical Center)
Hong, Taek Kyun (Department of Radiation Oncology, Asan Medical Center)
Kang, Tae Yeong (Department of Radiation Oncology, Asan Medical Center)
Beck, Geum Mun (Department of Radiation Oncology, Asan Medical Center)
Hong, Dong Ki (Department of Radiation Oncology, Asan Medical Center)
Yun, In Ha (Department of Radiation Oncology, Asan Medical Center)
Kim, Jin San (Department of Radiation Oncology, Asan Medical Center)
Publication Information
The Journal of Korean Society for Radiation Therapy / v.26, no.2, 2014 , pp. 247-256 More about this Journal
Abstract
Purpose : To assess target motion during radiotherapy by quantifying daily setup errors and inter-fractional and intra-fractional movements of pancreatic fiducials. Materials and Methods : Eleven patients were treated via stereotactic body radiotherapy (SBRT) with volumetric modulated arc therapy. Bony setup errors were calculated using cone beam computed tomography (CBCT). Inter-fractional and intrafractional fiducial (seed) motion was determined via cone beam computed tomography (CBCT) projections and orthogonal fluoroscopy. Results : Using an off-line correction protocol, setup errors were 0.0 (-1.7-4.0), 0.3 (-0.5-3.0), and 0.0 (-4.1-6.6) mm for the left-right, anterior-posterior, and superior-inferior directions respectively. Random inter-fractional setup errors in the mean fiducial positions were -0.1, -1.1, and -2.3 mm respectively. Intra-fractional fiducial margins were 9.9, 7.8, and 12.5 mm, respectively. Conclusion : Online inter-fractional and intra-fractional corrections based on daily kV images and CBCT expedites SBRT of pancreatic cancer. Importantly, inter-fractional and intra-fractional motion needs to be measured regularly during treatment of pancreatic cancer to account for variations in patient respiration.
Keywords
Cone beam computed tomography (CBCT); Inter-fraction; Intra-fraction; Fiducial Marker; volumetric-modulated arc therapy (V-MAT);
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