Volumetric modulated arc therapy for nasopharyngeal carcinoma patients with poor compliance: setup error and expansion margin of target volume
10.3760/cma.j.issn.1004-4221.2016.09.015
- VernacularTitle:配合度较差鼻咽癌患者VMAT摆位误差及靶区外扩距离的研究
- Author:
Jie CHEN
;
Wenxue ZHANG
;
Keqiang WANG
;
Zhichao GUO
;
Jun WU
;
Yongzhen CAO
;
Zhonghong LYU
- Publication Type:Journal Article
- Keywords:
Nasopharyngeal neoplasmsm/volumetric modulated arc therapy;
Setup error;
Target volume margin;
Dose distribution
- From:
Chinese Journal of Radiation Oncology
2016;25(9):971-974
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the setup error for nasopharyngeal carcinoma (NPC) patients with poor compliance using kV cone-beam computed tomography,and to calculate the expansion margin from the clinical target volume (CTV) to planning target volume (PTV).Methods In 45 NPC patients from 2013 to 2015,the setup error,95% confidence interval (CI)-1 for random error,and PTV-1 value were calculated.Moreover,in 16 NPC patients with poor compliance based on five verifications (random error not within 95% CI-1),the setup error,95% CI-2 for random error,and PTV-2 value were calculated.For the 16 special patients,PTV-1 and PTV-1 combined with PTV-2 were used to develop the plan-1 and plan-2,respectively.The dosimetric difference between plan-1 and plan-2 was evaluated.Results Both PTV-1 and PTV-2 had the largest expansion margin in the y direction.The CTV of plan-1 could not meet the requirement of the prescription dose after the setup error was introduced.Compared with plan-1,the V95% and D95 values for the CTV of plan-2 were increased by 6.26% and 4.43%,respectively.The D01 value was significantly larger in plan-2 than in plan-1 (P=0.005),which,however,met the clinical requirement.Conclusions In patients with poor compliance,the dose to target volume can be effectively elevated and the normal tissue can be spared from damage when PTV-1 combined with PTV-2 is selected as expansion margin.