Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지
DOI QR코드

DOI QR Code

Radial displacement of clinical target volume in node negative head and neck cancer

  • Jeon, Wan (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Wu, Hong-Gyun (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Song, Sang-Hyuk (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Jung-In (Department of Radiation Oncology, Kangbuk Samsung Hospital)
  • Received : 2012.03.02
  • Accepted : 2012.03.22
  • Published : 2012.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Materials and Methods: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. Results: The mean radial displacements were 2.26 (${\pm}1.03$) mm in the control group and 3.05 (${\pm}1.97$) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. Conclusion: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

Keywords

References

  1. Ferlito A, Rinaldo A, Devaney KO, et al. Prognostic signifi cance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. Oral Oncol 2002;38:747-51. https://doi.org/10.1016/S1368-8375(02)00052-0
  2. Magnano M, De Stefani A, Lerda W, et al. Prognostic factors of cervical lymph node metastasis in head and neck squamous cell carcinoma. Tumori 1997;83:922-6.
  3. Mamelle G, Pampurik J, Luboinski B, Lancar R, Lusinchi A, Bosq J. Lymph node prognostic factors in head and neck squamous cell carcinomas. Am J Surg 1994;168:494-8. https://doi.org/10.1016/S0002-9610(05)80109-6
  4. Stringer SP. Current concepts in surgical management of neck metastases from head and neck cancer. Oncology (Williston Park) 1995;9:547-54.
  5. Gregoire V, Levendag P, Ang KK, et al. CT-based delineation of lymph node levels and related CTVs in the node-negative neck: DAHANCA, EORTC, GORTEC, NCIC, RTOG consensus guidelines. Radiother Oncol 2003;69:227-36. https://doi.org/10.1016/j.radonc.2003.09.011
  6. van Asselen B, Raaijmakers CP, Lagendijk JJ, Terhaard CH. Intrafraction motions of the larynx during radiotherapy. Int J Radiat Oncol Biol Phys 2003;56:384-90. https://doi.org/10.1016/S0360-3016(02)04572-8
  7. Linthout N, Verellen D, Tournel K, Storme G. Six dimensional analysis with daily stereoscopic x-ray imaging of intrafraction patient motion in head and neck treatments using five points fixation masks. Med Phys 2006;33:504-13. https://doi.org/10.1118/1.2165417
  8. Zhang L, Garden AS, Lo J, et al. Multiple regions-of-interest analysis of setup uncertainties for head-and-neck cancer radiotherapy. Int J Radiat Oncol Biol Phys 2006;64:1559-69. https://doi.org/10.1016/j.ijrobp.2005.12.023
  9. Gilbeau L, Octave-Prignot M, Loncol T, Renard L, Scalliet P, Gregoire V. Comparison of setup accuracy of three different thermoplastic masks for the treatment of brain and head and neck tumors. Radiother Oncol 2001;58:155-62. https://doi.org/10.1016/S0167-8140(00)00280-2
  10. de Boer HC, van Sornsen de Koste JR, Creutzberg CL, Visser AG, Levendag PC, Heijmen BJ. Electronic portal image assisted reduction of systematic set-up errors in head and neck irradiation. Radiother Oncol 2001;61:299-308. https://doi.org/10.1016/S0167-8140(01)00437-6
  11. Boda-Heggemann J, Walter C, Rahn A, et al. Repositioning accuracy of two different mask systems-3D revisited: comparison using true 3D/3D matching with cone-beam CT. Int J Radiat Oncol Biol Phys 2006;66:1568-75. https://doi.org/10.1016/j.ijrobp.2006.08.054
  12. van Kranen S, van Beek S, Rasch C, van Herk M, Sonke JJ. Setup uncertainties of anatomical sub-regions in head-andneck cancer patients after offline CBCT guidance. Int J Radiat Oncol Biol Phys 2009;73:1566-73. https://doi.org/10.1016/j.ijrobp.2008.11.035
  13. Pehlivan B, Pichenot C, Castaing M, et al. Interfractional setup errors evaluation by daily electronic portal imaging of IMRT in head and neck cancer patients. Acta Oncol 2009;48:440-5. https://doi.org/10.1080/02841860802400610
  14. Barker JL Jr, Garden AS, Ang KK, et al. Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT/linear accelerator system. Int J Radiat Oncol Biol Phys 2004;59:960-70. https://doi.org/10.1016/j.ijrobp.2003.12.024
  15. McBain CA, Henry AM, Sykes J, et al. X-ray volumetric imaging in image-guided radiotherapy: the new standard in ontreatment imaging. Int J Radiat Oncol Biol Phys 2006;64:625-34. https://doi.org/10.1016/j.ijrobp.2005.09.018
  16. National Council on Radiation Protection and Measurements. Recent application of the NCRP public dose limit recommendation for ionizing radiation. Bethesda: National Council on Radiation Protection and Measurements; 2004. NCRP statement no. 10.

Cited by

  1. Vision 20/20: Perspectives on automated image segmentation for radiotherapy vol.41, pp.5, 2014, https://doi.org/10.1118/1.4871620
  2. Setup uncertainties for inter-fractional head and neck cancer in radiotherapy vol.7, pp.29, 2012, https://doi.org/10.18632/oncotarget.9748
  3. Patient positioning in head and neck cancer : Setup variations and safety margins in helical tomotherapy vol.194, pp.5, 2018, https://doi.org/10.1007/s00066-018-1265-7
  4. Positional uncertainties of cervical and upper thoracic spine in stereotactic body radiotherapy with thermoplastic mask immobilization vol.36, pp.2, 2012, https://doi.org/10.3857/roj.2017.00591
  5. Comparison of Intrafractional Motion in Head and Neck Cancer Between Two Immobilization Methods During Stereotactic Ablative Radiation Therapy by CyberKnife vol.12, pp.None, 2012, https://doi.org/10.2147/cmar.s283746