Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-23T11:59:11.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Set-up variation in palliative radiotherapy: one versus three skin localisation marks

Published online by Cambridge University Press:  08 November 2019

Jelizaveta Cvetkova ,
Agnella Craig ,
Theresa O’Donovan  and
Laura Mullaney Open the ORCID record for Laura Mullaney [Opens in a new window]
Jelizaveta Cvetkova
Affiliation:
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
Agnella Craig
Affiliation:
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
Theresa O’Donovan
Affiliation:
Radiation Oncology Department, Cork University Hospital, Wilton Road, Cork, Ireland
Laura Mullaney*
Affiliation:
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
*
Author for correspondence: Laura Mullaney, Discipline of Radiation Therapy, Trinity College Dublin, Trinity Building for Health Sciences, St James’s Hospital Campus, Dublin 8, Ireland, Tel: +353 1 896 3254. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Accuracy and reproducibility of the patient’s position is crucial for successful delivery of radiotherapy (RT). Data on palliative patients’ set-up uncertainties are sparse. The aim of this study was to calculate set-up errors observed for palliative patients positioned using one skin mark (Group 1) versus three skin marks (Group 2) and to assess the accuracy of both approaches.

Methods:

Displacements in the left–right (L–R) and superior–inferior (S–I) directions were retrospectively analysed for 175 sites treated with a course of fractionated palliative RT. Population mean, systematic and random errors were calculated in both directions for patients positioned with one and three skin marks. Frequency of deviations was also examined for both groups.

Results:

The population mean, systematic and random errors for Group 1 and 2 for the L–R direction were 0·0, 4·4, 4·8 and 0·4, 3·1 and 3·3 mm, respectively, and in the S–I direction: 0·1, 3·4, 4·2 and 1·2, 2·7 and 3·3 mm, respectively. Frequency of images within the clinical tolerance of 5 mm was 47·1% for Group 1 and 65·9% for Group 2.

Conclusion:

Three skin marks are recommended for patients receiving a fractionated course of palliative RT, as it reduces set-up error, reduces the number of gross displacements (>10 mm) and increases the number of displacements within the clinically acceptable tolerance of 5 mm.

Keywords

localisation protocols and palliative radiotherapypalliative imagingtreatment verification
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 206 - 209
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nieder, C, Pawinski, A, Haukland, E, Dokmo, R, Phillipi, I, Dalhaug, A.Estimating need for palliative external beam radiotherapy in adult cancer patients. Int J Radiat Oncol Biol Phys 2010; 76 (1): 207–211.CrossRefGoogle ScholarPubMed
Sztankay, A.Radiation therapy for palliation of cancer-related chronic pain. memo-Magazine Eur Med Oncol 2009; 2 (3): 173–176.CrossRefGoogle Scholar
Hurkmans, C W, Remeijer, P, Lebesque, J V, Mijnheer, B J.Set-up verification using portal imaging; review of current clinical practice. Radiother Oncol 2001; 58 (2): 105–120.CrossRefGoogle ScholarPubMed
Giraud, P, De Rycke, Y, Rosenwald, J-C, Cosset, J-M.Conformal radiotherapy planning for lung cancer: analysis of set-up uncertainties. Cancer Invest 2007; 25 (1): 38–46.CrossRefGoogle ScholarPubMed
Kataria, T, Abhishek, A, Chadha, P, Nandigam, J.Set-up uncertainties: online correction with X-ray volume imaging. J Cancer Res Ther 2011; 7 (1): 40.CrossRefGoogle ScholarPubMed
Young, L, Blyth, C.Assessment of set-up discrepancies using daily portal imaging during radiotherapy treatment for patients with spine and bone metastases. J Radiother Pract 2012; 11 (4): 209–216.CrossRefGoogle Scholar
Easton, D, Vavda, A, Cops, F, Goodridge, C, Leon, G, Scott, S.A quantitative portal imaging assessment of set-up discrepancies during radiation therapy for spinal metastases. Int J Radiat Oncol Biol Phys 2004; 60 (1): S562.CrossRefGoogle Scholar
The Royal College of Radiologists, Society and College of Radiographers, Institute of Physics and Engineering in Medicine. On Target: Ensuring Geometric Accuracy in Radiotherapy. London: The Royal College of Radiologists; 2008.Google Scholar
Morgan, T L, Banks, D A, Kagan, A R.Radiation therapy port films: a quality assurance study. Int J Radiat Oncol Biol Phys 1998; 42 (1): 223–227.CrossRefGoogle ScholarPubMed
Creutzberg, C L, Althof, V G, de Hoog, Met al.A quality control study of the accuracy of patient positioning in irradiation of pelvic fields. Int J Radiat Oncol Biol Phys 1996; 34 (3): 697–708.CrossRefGoogle ScholarPubMed
Johnston, M, Vial, P, Wiltshire, Ket al.Daily online bony correction is required for prostate patients without fiducial markers or soft-tissue imaging. Clin Oncol 2011; 23 (7): 454–459.CrossRefGoogle ScholarPubMed
Elsner, K, Francis, K, Hruby, G, Roderick, S.Quality improvement process to assess tattoo alignment, set‐up accuracy and isocentre reproducibility in pelvic radiotherapy patients. J Med Radiat Sci 2014; 61 (4): 246–252.CrossRefGoogle ScholarPubMed
Thilmann, C, Adamietz, I, Mose, S, Saran, F, Buchner, A, Böttcher, H.Which factors modify the reproducibility of patient positioning in the daily irradiation routine? Strahlentherapie und Onkologie 1997; 173 (8): 422–427.CrossRefGoogle ScholarPubMed