DOI QR코드

DOI QR Code

Analysis of setup error at rectal cancer radiotherapy technique

직장암 방사선치료기법별 자세오차에 관한 분석

  • Kim, Jeong-Ho (Department of Radiation Oncology, Konyang University Hospital) ;
  • Bae, Seok-Hwan (Division of Radiology, Konyang University) ;
  • Kim, Ki-Jin (Department of Nuclear Medicine, Konyang University Hospital) ;
  • Yu, Se-Jong (Department of Radiology, Konyang University Hospital) ;
  • Kim, Jee-Yoon (Hyejeon College, Dept. of Nursing)
  • 김정호 (건양대학교병원 방사선종양학과) ;
  • 배석환 (건양대학교 방사선학과) ;
  • 김기진 (건양대학교병원 핵의학과) ;
  • 유세종 (건양대학교병원 영상의학과) ;
  • 김지윤 (혜전대학교 간호학과)
  • Received : 2013.10.23
  • Accepted : 2013.12.05
  • Published : 2013.12.31

Abstract

Radiotherapy of rectal cancer requires a stabilized image but the movement of patients is almost unavoidable in radiotherapy. In this study, the setup error using the radiation treatment technique was compared according to the loading time and BMI(Body Mass Index) for 14 patients with rectal cancer. In addition, the variation of the dose by the average setup error was compared. Therefore, the technique of a selective standard was established. As a result, 3DCRT(3-Dimensional Radiation Therapy) and VMAT(Volumetric Modulated Arc Therapy) showed a similar time and error. In comparison, IMRT(Intensity Modulated Radiation Therapy) increased the time two fold and the error four fold. In BMI, a more pyknic patient showed a larger error for all techniques. Regarding the dose, IMRT and VMAT increased much more than 3DCRT in the average error at the small bowel. Therefore, 3DCRT of the short time will be applied to pyknic rectal cancer. Moreover, VMAT selects than IMRT in the overexposure of the small bowel.

Keywords

Conformity index;Homogeneity index;Quality of coverage;Radiotherapy technique;Rectal cancer

References

  1. A. Jemal, R. Siegel, E. Ward, "Cancer statistics", CA Cancer J Clin, 58, pp. 71-96, 2008. DOI: http://dx.doi.org/10.3322/CA.2007.0010 https://doi.org/10.3322/CA.2007.0010
  2. Goyang., National Cancer Information Center, http://www.cancer.go.kr/cms/statics/incidence, 2011 Jan 30.
  3. H. C. Park, D. H. Choi, "Radiation Therapy for Colorectal Cancer", J Korea Med Assoc, 53(7), pp. 592-602, 2010. DOI: http://dx.doi.org/10.5124/jkma.2010.53.7.592 https://doi.org/10.5124/jkma.2010.53.7.592
  4. K. L. Baglan, R. C. Frazier, D. Yan, R. R. Huang, A. A. Martinez, J. M. Robertson, "The dose-volume relationship of acute small bowel toxicity from concurrent 5-FU-based chemotherapy and radiation therapy for rectal cancer", Int J Radiat Oncol Biol Phys., 52, pp. 176-183. 2002. DOI: http://dx.doi.org/10.1016/S0360-3016(01)01820-X https://doi.org/10.1016/S0360-3016(01)01820-X
  5. M. J. Gallagher, H. D. Brereton, R. A. Rostock, J. M. Zero, D. A. Zekoski, L. F. Poyss, M. P. Richter, M. M. Kligerman, "A prospective study of treatment techniques to minimize the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation.", Int J Radiat Oncol Biol Phys, 12, pp. 1565-1573, 1986. DOI: http://dx.doi.org/10.1016/0360-3016(86)90279-8 https://doi.org/10.1016/0360-3016(86)90279-8
  6. T. G. Shanahan, M. P. Mehta, K. L. Bertelrud, "Minimization of small bowel volume within treatment fields utilizing customized belly boards", Int J Radiat Oncol Biol Phys, 19, pp. 469-476, 1990. DOI: http://dx.doi.org/10.1016/0360-3016(90)90559-3 https://doi.org/10.1016/0360-3016(90)90559-3
  7. I. J. Das, R. M. Lanciano, B. Movsas, K. Kagawa, S. J. Barnes, "Efficacy of a belly board device with CT-simulation in reducing small bowel volume within pelvic irradiation fields", Int J Radiat Oncol Biol Phys, 39, pp. 67-76, 1997. https://doi.org/10.1016/S0360-3016(97)00310-6
  8. S. J. Huh, D. H. Lim, Y. C. Ahn, "Effect of customized small bowel displacement system in pelvic irradiation", Int J Radiat Oncol Biol Phys, 40, pp. 623-627, 1998. DOI: http://dx.doi.org/10.1016/S0360-3016(97)00764-5 https://doi.org/10.1016/S0360-3016(97)00764-5
  9. T. H. Kim, E. K. Chie, D. Y. Kim, "Comparison of the belly board device method and the distended bladder method for reducing irradiated small bowel volumes in preoperative radiotherapy of rectal cancer patients", Int J Radiat Oncol Biol Phys, 62, pp. 769-775, 2005. DOI: http://dx.doi.org/10.1016/j.ijrobp.2004.11.015 https://doi.org/10.1016/j.ijrobp.2004.11.015
  10. K. J. Lee, "The 3-dimensional analysis of the efficacy of a belly-board device for the displacement of small bowel during pelvic irradiation", J Korean Soc Ther Radiol Oncol, 26, pp. 271-279, 2008. DOI: http://dx.doi.org/10.3857/jkstro.2008.26.4.271 https://doi.org/10.3857/jkstro.2008.26.4.271
  11. P. C. Koper, P. Jansen, W. Putten, "Gastro-intestinal and genito-urinary morbidity after 3D conformal radiotherapy of prostate cancer", Radiat oncol, 73, pp. 1-9, 2004. https://doi.org/10.1016/j.radonc.2004.07.020
  12. J. M. Michalski, K. Winter, J. A. Purdy, "Preliminary evaluation of low-grade toxicity with conformal radiation therapy for prostate cancer on RTOG 9406 dose levels I and II", Int J Radiat Oncol Biol Phys, 56, pp. 192-198, 2003. https://doi.org/10.1016/S0360-3016(03)00072-5
  13. M. J. Zelefsky, D. Cowen, Z. Fuks, "Long term tolerance of high dose three-dimensional conformal radiotherapy in patients with localized prostate carcinoma", Cancer, 85, pp. 2460-2468, 1999. DOI: http://dx.doi.org/10.1002/(SICI)1097-0142(19990601) 85:11<2460::AID-CNCR23>3.0.CO;2-N https://doi.org/10.1002/(SICI)1097-0142(19990601)85:11<2460::AID-CNCR23>3.0.CO;2-N
  14. M. J. Zelefsky, Z. Fuks, L. Happersett, "Clinical experience with intensity modulated radiation therapy(IMRT) in prostate cancer", Radiother Oncol, 55, pp. 241-249, 2000. DOI: http://dx.doi.org/10.1016/S0167-8140(99)00100-0 https://doi.org/10.1016/S0167-8140(99)00100-0
  15. J. P. Gerard, O. Chapet, C. Nemoz, "Improved sphincter preservation in low rectal cancer with high dose preoperative radiotherapy: the lyon R96-02 randomized trial", J Clin Oncol, 22, pp. 2404-2409, 2004. DOI: http://dx.doi.org/10.1200/JCO.2004.08.170 https://doi.org/10.1200/JCO.2004.08.170
  16. L. J. Verhey, "Comparison of three-dimensional conformal radiation therapy and intensity modulated radiation therapy systems", Semin Radiat Oncol, 9(1), pp. 78-98, 1999. DOI: http://dx.doi.org/10.1016/S1053-4296(99)80056-3 https://doi.org/10.1016/S1053-4296(99)80056-3
  17. S. H. Benedict, R. M. Cardinale, Q. Wu, R. D. Zwicker, W. C. Broaddus, R. Mohan, "Intensity modulated stereotactic radiosurgery using dynamic micro-multileaf collimation", Int J Radiat Oncol Biol Phys, 50(3), pp. 751-758, 2001. DOI: http://dx.doi.org/10.1016/S0360-3016(01)01487-0 https://doi.org/10.1016/S0360-3016(01)01487-0
  18. R. G. J. Wiggenraad, A. L. Petoukhova, L. Versluis, J. P. C. van Santvoort, "Stereotactic radiotherapy of intracranial tumors: A comparison of intensity-modulated radiotherapy and dynamic conformal arc", Int J Radiat Oncol Biol Phys, 74(4), pp. 1018-1026, 2009. DOI: http://dx.doi.org/10.1016/j.ijrobp.2008.09.057 https://doi.org/10.1016/j.ijrobp.2008.09.057
  19. G. Budgell, "Intensity modulated radiotherapy (IMRT) and introduction", Radiography, 8, pp. 241-249, 2000. DOI: http://dx.doi.org/10.1053/radi.2002.0390 https://doi.org/10.1053/radi.2002.0390
  20. E. Ludlum, C. Akazawa, P. Xia, "IMRT plans can be simplified using one step optimization", Med Phys. 33, pp. 2111, 2006. DOI: http://dx.doi.org/10.1118/1.2241198 https://doi.org/10.1118/1.2241198
  21. K. Otto, "Volumetric modulated arc therapy: IMRT in a single gantry arc", Med Phys, 35, pp, 310-317, 2008. https://doi.org/10.1118/1.2818738
  22. M. Rao, W. Yang, F. Chen, "Comparison of Elekta VMAT with helical tomotherapy and fixed field IMRT: Plan quality, delivery efficiency and accuracy", Med Phy, 37, pp. 1350-1359, 2010. DOI: http://dx.doi.org/10.1118/1.3326965 https://doi.org/10.1118/1.3326965
  23. J. H. Kim, D. Y. Kim, Y. H. Kim, W. C. Kim, C. Y. Kim, J. S. Seong, S. C. Sohn, H. S. Shin, Y. C. Ahn, D. H. Oh, W. Y. Oh, M. R. Ryu, H. J. Yoo, K. J. Lee, K. C. Lee, M. S. Chun, H. J. Chun, S. E. Hong, I. H. Kim, "Survey on Radiotherapy Protocols for the Rectal Cancers among the Korean Radiation Oncologists in 2002 for the Development of the Patterns of Care Study of Radiation Therapy", J Korean Soc Ther Radiol Oncol, 21, pp. 44-53, 2003.
  24. B. Yao, M. Zheng, P. Wang, "Dosimetric study of five-field intensity-modulated radiotherapy compared with conventional three-dimensional conformal radiotherapy for rectal cancer", Chinese-German J Clin Oncol, 8, pp. 607-610, 2009. DOI: http://dx.doi.org/10.1007/s10330-009-0130-7 https://doi.org/10.1007/s10330-009-0130-7
  25. G. Delaney, S. Jacob, C. Featherstone, M. Barton, "The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines", Cancer, 104, pp. 1129-37, 2005. DOI: http://dx.doi.org/10.1002/cncr.21324 https://doi.org/10.1002/cncr.21324
  26. WHO, World Health Organization. Radiotherapy risk profile, WHO Publication, 2008.
  27. J. H. Kim, "Categorizing accident sequences in the external radiotherapy for risk analysis", Radiat Oncol J, 31(2), pp. 88-96, 2013. DOI: http://dx.doi.org/10.3857/roj.2013.31.2.88 https://doi.org/10.3857/roj.2013.31.2.88
  28. J. S. Bae, H. J. Joung, J. Y. Kim, K. N. Kwon, Y. J. Kim, S. W. Park, "Validity of Self-Reported Height, Weight, and Body Mass Index of the Korea Youth Risk Behavior Web- Based Survey Questionnaire", J Prev Med Public Health, 43, pp. 396-402, 2010. DOI: http://dx.doi.org/10.3961/jpmph.2010.43.5.403 https://doi.org/10.3961/jpmph.2010.43.5.403
  29. L. Feuvret, G. Noel, J. J. Mazeron, "Conformity index: A review", Int J Radiation Oncology Biol Phys, 64, pp. 333-342, 2006. DOI: http://dx.doi.org/10.1016/j.ijrobp.2005.09.028 https://doi.org/10.1016/j.ijrobp.2005.09.028
  30. W. R. Lee, L. Daniel, RTOG 0415: A phase III randomized study of hypofractionated 3D-CRT/IMRT versus conventionally fractionated 3D-CRT/IMRT in patients with favorable-risk prostate cancer, Radiation Therapy Oncology Group, Mahul, 2009.

Cited by

  1. Study on the Validation of the Gated Cone-Beam Computed Tomography on Radiation Therapeutic Linear Accelerator vol.16, pp.10, 2015, https://doi.org/10.5762/KAIS.2015.16.10.6932