Comparison of two immobilization techniques using portal film and digitally reconstructed radiographs for pediatric patients with brain tumors

Zhu, Yun; Stovall, J.P.; Butler, Laura; Ji, Qing; Gaber, M. Waleed; Samant, S; Sontag, Marc R.; Armendi, Alberto J. de; Merchant, Thomas E.

doi:10.1016/s0360-3016(00)00733-1

Cited by 23 publications

(18 citation statements)

References 6 publications

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“…Given the importance and complexity in determining the appropriate PTV margin, a number of studies have proposed patient population-based formulas for the patient-related portion of the setup margin (8–11) to allow for systematic quantification of setup uncertainties based on statistical methods. Among the sites under study, intracranial (12, 13) and head and neck (14–17) sites are of particular interest; however, only two small studies have been published focusing on pediatric localization (18, 19). …”

Section: Introductionmentioning

confidence: 99%

Inter- and Intrafractional Positional Uncertainties in Pediatric Radiotherapy Patients With Brain and Head and Neck Tumors

Beltran

Krasin

Merchant

2011

International Journal of Radiation Oncology*Biology*Physics

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Purpose To estimate radiation therapy planning margins based on inter- and intrafractional uncertainty for pediatric brain and head and neck tumor patients at different imaging frequencies. Methods Pediatric patients with brain (n = 83) and head and neck (n = 17) tumors (median age = 7.2 years) were enrolled on an internal review board–approved localization protocol and stratified according to treatment position and use of anesthesia. Megavoltage cone-beam CT (CBCT) was performed before each treatment and after every other treatment. The pretreatment offsets were used to calculate the interfractional setup uncertainty (SU), and posttreatment offsets were used to calculate the intrafractional residual uncertainty (RU). The SU and RU are the patient-related components of the setup margin (SM), which is part of the planning target volume (PTV). SU data was used to simulate four intervention strategies using different imaging frequencies and thresholds. Results The SM based on all patients treated on this study was 2.1 mm (SU = 0.9 mm, RU = 1.9 mm) and varied according to treatment position (supine = 1.8 mm, prone = 2.6 mm) and use of anesthesia (with = 1.7 mm, without = 2.5 mm) because of differences in the RU. The average SU for a 2-mm threshold based on no imaging, once per week imaging, initial five images, and daily imaging was 3.6, 2.1, 2.2, and 0.9 mm, respectively. Conclusion On the basis of this study, the SM component of the PTV may be reduced to 2 mm for daily CBCT compared with 3.5 mm for weekly CBCT. Considering patients who undergo daily pretreatment CBCT, the SM is larger for those treated in the prone position or smaller for those treated under anesthesia because of differences in the RU.

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Section: Introductionmentioning

confidence: 99%

Inter- and Intrafractional Positional Uncertainties in Pediatric Radiotherapy Patients With Brain and Head and Neck Tumors

Beltran

Krasin

Merchant

2011

International Journal of Radiation Oncology*Biology*Physics

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“…Daily reproducibility of patient positioning allows for more precise irradiation of the tumor site with subsequent reductions in healthy tissue irradiation and acute and chronic adverse effects. 5 When children are unable to maintain a fixed and reproducible position required for treatment, the success of RT is compromised, and anesthesia will likely be required.…”

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confidence: 99%

Predicting Pediatric Distress During Radiation Therapy Procedures: The Role of Medical, Psychosocial, and Demographic Factors

Klosky

Tyc²,

Tong

et al. 2007

Pediatrics

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“…Many immobilization systems are commercially available, and several clinical evaluations have been performed (4,6,7,(11)(12)(13)(14)(15)(16)(17). These studies have documented the frequency of physician-requested treatment changes (6) or the reproducibility of the fixation of the patient's head within the mask, as measured by deviations on the port films (4,7,(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

“…These studies have documented the frequency of physician-requested treatment changes (6) or the reproducibility of the fixation of the patient's head within the mask, as measured by deviations on the port films (4,7,(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Randomized trial on two types of thermoplastic masks for patient immobilization during radiation therapy for head-and-neck cancer

Sharp¹,

Lewin²,

Johansson³

et al. 2005

International Journal of Radiation Oncology*Biology*Physics

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Comparison of two immobilization techniques using portal film and digitally reconstructed radiographs for pediatric patients with brain tumors

Cited by 23 publications

References 6 publications

Inter- and Intrafractional Positional Uncertainties in Pediatric Radiotherapy Patients With Brain and Head and Neck Tumors

Inter- and Intrafractional Positional Uncertainties in Pediatric Radiotherapy Patients With Brain and Head and Neck Tumors

Predicting Pediatric Distress During Radiation Therapy Procedures: The Role of Medical, Psychosocial, and Demographic Factors

Randomized trial on two types of thermoplastic masks for patient immobilization during radiation therapy for head-and-neck cancer

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