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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Set-up improvement in head and neck radiotherapy using a 3D off-line EPID-based correction protocol and a customised head and neck support.
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Set-up improvement in head and neck radiotherapy using a 3D off-line EPID-based correction protocol and a customised head and neck support.

机译：使用基于3D离线EPID的校正协议和定制的头颈支持，可以改善头颈放射治疗的设置。

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PURPOSE: First, to investigate the set-up improvement resulting from the introduction of a customised head and neck (HN) support system in combination with a technologist-driven off-line correction protocol in HN radiotherapy. Second, to define margins for planning target volume definition, accounting for systematic and random set-up uncertainties. METHODS AND MATERIALS: In 63 patients 498 treatment fractions were evaluated to develop and implement a 3D shrinking action level correction protocol. In the comparative study two different HN-supports were compared: a flexible 'standard HN-support' and a 'customised HN-support". For all three directions (x, y and z) random and systematic set-up deviations (1S.D.) were measured. RESULTS: The customised HN-support improves the patient positioning compared to the standard HN-support. The 1D systematic errors in the x, y and z directions were reduced from 2.2-2.3 mm to 1.2-2.0 mm (1S.D.). The 1D random errors for the y and z directions were reduced from 1.6 and1.6 mm to 1.1 and 1.0 mm (1S.D.). The correction protocol reduced the 1D systematic errors further to 0.8-1.1 mm (1S.D.) and all deviations in any direction were within 5 mm. Treatment time per measured fraction was increased from 10 to 13 min. The total time required per patient, for the complete correction procedure, was approximately 40 min. CONCLUSIONS: Portal imaging is a powerful tool in the evaluation of the department specific patient positioning procedures. The introduction of a comfortable customised HN-support, in combination with an electronic portal imaging device-based correction protocol, executed by technologists, led to an improvement of overall patient set-up. As a result, application of proposed recipes for CTV-PTV margins indicates that these can be reduced to 3-4 mm.
机译：目的：首先，研究在HN放射治疗中引入定制的头颈（HN）支持系统与技术人员驱动的离线校正协议相结合所带来的设置改进。其次，为计划目标量定义定义边际，并考虑系统和随机设置的不确定性。方法和材料：在63位患者中，对498个治疗组分进行了评估，以制定和实施3D收缩作用水平校正方案。在比较研究中，比较了两种不同的HN支撑：灵活的“标准HN支撑”和“定制HN支撑”，对于所有三个方向（x，y和z），随机和系统设置偏差（1S。结果：定制的HN支架与标准HN支架相比可改善患者的位置，x，y和z方向的一维系统误差从2.2-2.3 mm减小至1.2-2.0 mm（ y和z方向的一维随机误差从1.6和1.6 mm减小到1.1和1.0 mm（1S.D.）。校正方案将一维系统误差进一步减小到0.8-1.1 mm （1S.D.）并且任何方向的所有偏差都在5毫米之内。每个测量分数的治疗时间从10分钟增加到13分钟。完整矫正程序所需的每位患者总时间约为40分钟。门诊成像是评估部门特定患者定位程序的有力工具。舒适的定制HN支持与技术人员执行的基于电子门禁成像设备的校正协议相结合，改善了患者的整体状况。结果，对CTV-PTV边距的建议配方应用表明这些可以减小到3-4毫米。

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