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Daily patient geometry correction: application of NAL and eNAL protocols

Dąbrowski Andrzej, Zielińska-Dąbrowska Sylwia, Kuszewski Tomasz, Lis Krzysztof

Polish Journal of Medical Physics and Engineering

2020

Vol. 26, Iss. 4

181--184

Purpose: To test the NAL and eNAL correction protocols using daily patient setup displacements. Methods and material: In total, the analysis was performed for 749 and 797 kV CBCT images for gynecological and prostate patients, respectively, each of 30 patients. After the planning procedure, patients were set up on the treatment table in the treatment position every day. The on-line correction protocol was applied. KV CBCT images were acquired by means of x-ray lamp mounted orthogonally on Linac. Patient setup displacement was assigned. NAL and eNAL corrections protocols were simulated using daily data from online corrections for these two groups of patients. The overall systematic error and random error were calculated for each direction. Results: For the prostate group, the random errors for daily Raw data (no correction) in LAT, LONG, and VERT directions were 2.0 mm, 1.6 mm, and 3.2 mm, respectively. For NAL and eNAL protocols, they were in the range of 1.8 mm to 3.2 mm. For the gynecological group, the random errors were: for daily Raw data 2.2 mm, 1.7 mm, and 3.2 mm, respectively. For NAL and eNAL protocols, they were in the range of 2.0 to 3.4 mm. For the prostate group, values of systematic errors 1.8 mm, 1.8 mm, and 3.3 mm, respectively for Raw data. For NAL and eNAL protocols, these values were less than 1.8 mm. For the gynecological group, the systematic errors were 2.6 mm, 2.3 mm, and 2.8 mm, respectively, for Raw data. For NAL ana eNAL protocols less than 1.8 mm. For the gynecological group, for Raw data, 45% of the total displacement vectors exceeded 5 mm, whereas only 25% did after the NAL procedure and 29% after the eNAL procedure. For the prostate group, for Raw data, 34% of the total displacement vectors exceeded 5 mm, whereas only 22% did after NAL procedure and 28% after eNAL procedure Conclusions: For gynecological and prostate cancer patients, the NAL and eNAL correction protocols can be safely applied to substantially reduce setup errors.

Wyniki odtwarzalności ułożenia pacjentów napromienianych wiązkami zewnętrznymi w Centrum Onkologii – Instytucie w Warszawie w roku 2017

Kukołowicz Paweł, Czuchraniuk Piotr, Kmita Agnieszka, Mazur Monika, Jancewicz Katarzyna, Niebyłowska Daria, Mazur Waldemar, Przybyś Alicja

Inżynier i Fizyk Medyczny

2019

Vol. 8, nr 2

127--130

Kontrola odtwarzalności ułożenia jest istotnym elementem zapewnienia bezpieczeństwa radioterapii. Wykonywana u każdego leczonego pacjenta umożliwia zmniejszenie rozbieżności pomiędzy planem i jego realizacją. Analiza wyników kontroli ułożenia przeprowadzonych w dłuższym czasie umożliwia ogólną ocenę jakości napromieniania. W tej pracy przedstawiono, zgromadzone w 2017 roku, wyniki kontroli ułożenia w 5 jednorodnych grupach pacjentów leczonych z powodu nowotworów głowy i szyi, nowotworów piersi, nowotworów tkanek miękkich, przewodu pokarmowego górnego i nowotworów ginekologicznych napromienianych w Centrum Onkologii – Instytucie w Warszawie na Ursynowie. Kontrolę przeprowadzano w pierwszych trzech sesjach terapeutycznych. Wyniki są zaprezentowane w kategoriach błędów przypadkowych i systematycznych.

The setup control is an important part of the quality assurance of the external radiotherapy. It enables diminishing the observed discrepancies between the treatment plan and its actualization. The analysis of the data of setup control collected in the radiotherapy department for the longer period of time enables the evaluation of the quality of the irradiation. In this article the results of setup control for the patients irradiated in the Memorial Maria Sklodowska-Curie Cancer Center Institute of Oncology, collected for the 5 locations (head&neck, breast, sarcomas, the upper digestive tract and gynecology) in 2017 year are presented. The setup control was performed in the first free treatment sessions. The results are presented in terms of random and systematic setup errors.