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Simulation accuracy in radiotherapy for maxillary sinus tumors

C G Niël¹, J P van Santvoort, J R van Sörnsen-de Koste

¹Department of Radiation Oncology, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.

International Journal of Radiation Oncology, Biology, Physics

|June 15, 1995

Summary

Radiation therapy simulation for maxillary sinus tumors can lead to geographical misses due to inaccurate beam positioning using bony landmarks. Using external localization frames improves accuracy and reduces treatment errors.

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Area of Science:

Radiation oncology
Medical imaging
Radiotherapy physics

Background:

Accurate beam positioning is crucial for effective radiation therapy.
Maxillary sinus tumors require precise targeting to minimize damage to surrounding healthy tissues.

Purpose of the Study:

To assess the accuracy of beam positioning during radiation treatment simulation for maxillary sinus tumors.
To evaluate the clinical significance of beam positioning errors in this patient group.

Main Methods:

Five patients with maxillary sinus tumors underwent simulation using computed tomography (CT) scans.
Beam positioning was initially guided by bony anatomical structures.
The simulation was repeated using a noninvasive external localization frame with known accuracy (within 2 mm).

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Main Results:

Using bony landmarks for beam positioning resulted in partial geographical misses in 3 out of 5 patients.
These errors occurred when defining the clinical target volume with a 1 cm margin.
The study analyzed the impact of these errors on normal tissue complication and tumor control probabilities.

Conclusions:

A margin should be included in the planning target volume to account for potential simulation errors.
Objective, external landmarks are recommended for simulation to minimize the required safety margin.
If bony structures are used, an additional margin is necessary, dependent on achievable simulation accuracy.