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Technical note: improved positioning protocol for patient setup accuracy in conventional radiotherapy for lung cancer
Hongbo Chai1, Yuichiro Narita2, Masafumi Takagi3
1Department of Radiation Therapy, Hirosaki Central Hospital, 3-1 Yoshino-cho, Hirosaki, Aomori, 036-8188, Japan. honbo.chai@gmail.com.
Radiological Physics and Technology
|September 25, 2019
Summary
This study introduces an improved setup protocol for lung cancer radiotherapy, reducing the need for frequent image guidance. The new method ensures high patient setup accuracy, with 97% of fractions within 2 mm error margins.
Area of Science:
- Radiation Oncology
- Medical Physics
- Cancer Treatment
Background:
- Accurate patient positioning is crucial in lung cancer radiotherapy.
- Conventional radiotherapy often relies on frequent image-guided radiation therapy (IGRT) for setup accuracy.
- Minimizing IGRT can reduce treatment time and resource utilization.
Purpose of the Study:
- To investigate an improved setup protocol for lung cancer radiotherapy.
- To maintain patient setup accuracy with minimal or no IGRT.
- To assess the efficacy of a single-image guidance protocol.
Main Methods:
- A protocol using the first fraction's couch coordinate in the anterior-posterior (AP) direction was implemented.
- This coordinate was consistently used for subsequent treatment fractions.
- Analysis of 2410 setup image sets from 105 lung cancer patients.
Main Results:
- The systematic and random patient positioning errors in the AP direction were minimal (0.6 ± 1.0 mm).
- 97% of all fractions achieved setup accuracy within ±2 mm.
- The protocol demonstrated high accuracy with only one initial image guidance.
Conclusions:
- The improved setup protocol effectively maintains patient setup accuracy in lung cancer radiotherapy.
- This method significantly reduces reliance on IGRT.
- The protocol is suitable for conventional radiotherapy when IGRT resources are limited.
