Precision required for dose-escalated treatment of spinal metastases and implications for image-guided radiation therapy (IGRT)

被引：63

作者：

Guckenberger, Matthias ^{[1
]}

Meyer, Juergen ^{[1
]}

Wilbert, Juergen ^{[1
]}

Baier, Kurt ^{[1
]}

Bratengeier, Klaus ^{[1
]}

Vordermark, Dirk ^{[1
]}

Flentje, Michael ^{[1
]}

机构：

[1] Univ Wurzburg, Dept Radiat Oncol, D-97080 Wurzburg, Germany

来源：

RADIOTHERAPY AND ONCOLOGY | 2007年 / 84卷 / 01期

关键词：

spinal metastasis; image-guided radiotherapy (IGRT); rotational set-up errors; cone-beam CT; intensity-modulated radiotherapy (IMRT); EXTRACRANIAL STEREOTACTIC RADIOTHERAPY; INTENSITY-MODULATED RADIOTHERAPY; PATIENT SETUP ERRORS; CONE-BEAM CT; PROGNOSTIC-FACTORS; COMPUTED-TOMOGRAPHY; PARASPINAL TUMORS; CLINICAL-PRACTICE; CORD COMPRESSION; SCORING SYSTEM;

D O I：

10.1016/j.radonc.2007.05.021

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: To evaluate the precision required in dose-escalated IMRT treatment of spinal metastases and paraspinal tumors. Methods: In IMRT treatment plans of nine patients with spinal metastases (n = 7) and paraspinal tumors (n = 2) translational patient positioning errors (0-10 mm) and rotational errors (0-7.5 degrees) were simulated. The dose to the spinal cord (D5(spine)) resulting from these simulations was evaluated and NTCP for spinal cord necrosis was calculated. All patient set-up errors observed during treatment were simulated and the influence on D5(spine) was investigated. Results: To keep the dose distribution to the spinal cord within 5% (+/- 10%) of the prescribed dose, maximum tolerable errors of I mm (2 mm) in the transversal plane, 4 mm (7 mm) in superior-inferior direction and maximum rotations of 3.5 degrees (5 degrees) were calculated on average. The translational and rotational component of clinically observed set-up errors increased D5(spine) by 23 +/- 14% and 3 +/- 2% on average, respectively. Conclusion: Steep dose gradients of IMRT planning require very high precision. In selected patients correction of both translational and rotational errors may be beneficial. (c) 2007 Elsevier Ireland Ltd. All rights reserved.

引用

页码：56 / 63

页数：8

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