Med Biol Eng Comput - A simulation technique for computation of the dosimetric effects of setup, organ motion and delineation uncertainties in radiotherapy.

Tópicos

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Resumo

In this study, we introduce a novel simulation technique to incorporate delineation errors into radiotherapy treatment margins and combine them with organ motion and set-up errors to investigate the cumulative dosimetric effects in different tumour sites. The effects of applying patient realignment correction protocols for radical treatments of prostate, lung and brain tumours were also modelled. Simulations were based on data from measurements using image-guidance techniques, including the use of fiducial markers in prostate and breathing correction techniques for the lung. The use of different sizes of planning target volume (PTV) margins was also evaluated. The prostate clinical target volumes' V99% showed up to 3.2% improvement with reduction in treatment uncertainties. For the lung plans, the V99% increased by up to an average of 10% with increase in treatment margin size from 0.5 to 1.5 cm. This improvement was, however, at the detriment of the dose delivered to the critical organs where the maximum dose received by the spinal cord increased by up to 0.5 Gy per fraction. These results were used to deduce the possible margin reductions and dose escalation achievable with reduced uncertainties.

Resumo Limpo

studi introduc novel simul techniqu incorpor delin error radiotherapi treatment margin combin organ motion setup error investig cumul dosimetr effect differ tumour site effect appli patient realign correct protocol radic treatment prostat lung brain tumour also model simul base data measur use imageguid techniqu includ use fiduci marker prostat breath correct techniqu lung use differ size plan target volum ptv margin also evalu prostat clinic target volum v show improv reduct treatment uncertainti lung plan v increas averag increas treatment margin size cm improv howev detriment dose deliv critic organ maximum dose receiv spinal cord increas gy per fraction result use deduc possibl margin reduct dose escal achiev reduc uncertainti

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