Re-irradiation of spinal column metastases by IMRT: impact of setup errors on the dose distribution

Groeger, Christian and Hautmann, Matthias G. and Loeschel, Rainer and Repp, Natalia and Koelbl, Oliver and Dobler, Barbara (2013) Re-irradiation of spinal column metastases by IMRT: impact of setup errors on the dose distribution. RADIATION ONCOLOGY, 8: 269. ISSN 1748-717X,

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Abstract

Background: This study investigates the impact of an automated image guided patient setup correction on the dose distribution for ten patients with in-field IMRT re-irradiation of vertebral metastases. Methods: 10 patients with spinal column metastases who had previously been treated with 3D-conformal radiotherapy (3D-CRT) were simulated to have an in-field recurrence. IMRT plans were generated for treatment of the vertebrae sparing the spinal cord. The dose distributions were compared for a patient setup based on skin marks only and a Cone Beam CT (CBCT) based setup with translational and rotational couch corrections using an automatic robotic image guided couch top (Elekta - HexaPOD (TM) IGuide (R) - system). The biological equivalent dose (BED) was calculated to evaluate and rank the effects of the automatic setup correction for the dose distribution of CTV and spinal cord. Results: The mean absolute value (+/- standard deviation) over all patients and fractions of the translational error is 6.1 mm (+/- 4 mm) and 2.7 degrees (+/- 1.1 mm) for the rotational error. The dose coverage of the 95% isodose for the CTV is considerable decreased for the uncorrected table setup. This is associated with an increasing of the spinal cord dose above the tolerance dose. Conclusions: An automatic image guided table correction ensures the delivery of accurate dose distribution and reduces the risk of radiation induced myelopathy.

Item Type: Article
Uncontrolled Keywords: INTENSITY-MODULATED RADIOTHERAPY; CORD COMPRESSION; RADIOSURGERY; RETREATMENT; RT; CBCT; Setup error; IGRT; IMRT; Spinal metastasis
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Strahlentherapie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 26 Mar 2020 09:45
Last Modified: 26 Mar 2020 09:45
URI: https://pred.uni-regensburg.de/id/eprint/15668

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