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An investigation of rotational issues for rectal carcinoma treated with radiotherapy

Published online by Cambridge University Press:  23 May 2013

Dominique A. Taylor*
Affiliation:
Andrew Love Cancer Centre, The Geelong Hospital, Geelong, Victoria, Australia
Thomas ffrench
Affiliation:
Andrew Love Cancer Centre, The Geelong Hospital, Geelong, Victoria, Australia
Charlotte A. Sale
Affiliation:
Andrew Love Cancer Centre, The Geelong Hospital, Geelong, Victoria, Australia
Paul Foulstone
Affiliation:
Andrew Love Cancer Centre, The Geelong Hospital, Geelong, Victoria, Australia
*
Correspondence to: Dominique Taylor, Andrew Love Cancer Centre, The Geelong Hospital, Geelong, Victoria 3220, Australia. Tel: +61 3 4215 2600. Fax: +61 3 4215 2669. E-mail: [email protected]

Abstract

Purpose

To quantify the amount of inter-fractional pitch for rectal carcinoma patients, to investigate the dosimetric impact of pitch on the target volume and critical structures and to determine a tolerance where no pitch correction is required.

Materials and methods

Daily pre-treatment images of rectal carcinoma patients were analysed to determine the residual pitch compared with the computed tomography (CT) planning scan. The dosimetric impact of pelvic rotation was modelled. The dose coverage of the clinical target volume (CTV) and small bowel were evaluated using dose–volume histograms.

Results

Pre-treatment images had a mean of 0·27° and standard deviation was 2·23°. The volume of CTV receiving 95% of the prescription dose altered by 0·1% when up to ±10° of pitch was simulated.

Conclusions

No clinically significant change in CTV coverage was found (when ±10° of pitch was simulated). A tolerance of ±10° of pitch has been implemented for rectal carcinoma patients treated with three-dimensional conformal radiotherapy in our institution, when daily pre-treatment imaging with a zero action threshold for translational shifts is used.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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