The contribution of surgical clips for optimizing highly-conformal image-guided flank irradiation in pediatric renal tumors: A single center experience

Pediatric radiotherapy for thoracic and abdominal targets: Organ motion, reported margin sizes, and delineation variations – A systematic review

“…For the distance of the tumor position between two expiration phases, a mean intrafractional motion of 7.1 mm (range 1.2-13.5 mm) in CC direction was found [36]. Two of the three studies also reported inter-and/or intrafractional tumor bed motion in LR and AP direction [15,41] (Appendix C).…”

“…Three studies (totaling N pat = 53) reported inter-and/or intrafractional tumor (bed) motion [15,36,41]. One study used 4DCT (N image = 15) and CBCTs (N image = 188) (Tables 1 and 2) to assess motion of the superior clip of the tumor bed using the COM, and reported a mean interfractional motion of 1.0 mm (range À3.2-4.6 mm) and a mean intrafractional motion of 0.8 mm (range 0.0-3.3 mm), both in CC direction [15].…”

“…One study used 4DCT (N image = 15) and CBCTs (N image = 188) (Tables 1 and 2) to assess motion of the superior clip of the tumor bed using the COM, and reported a mean interfractional motion of 1.0 mm (range À3.2-4.6 mm) and a mean intrafractional motion of 0.8 mm (range 0.0-3.3 mm), both in CC direction [15]. Another study used 4DCT (N = 30) to assess intrafractional motion between breathing phases using the COM and reported a mean motion of 1.2 mm (range À1.8-4.8 mm) of the superior clip of the tumor bed in CC direction [41]. The third study quantified intrafractional tumor motion using 4DMRI registered to 3DCT scans.…”

“…Most commonly reported margins types were GTV-CTV and CTV-PTV margins for thoracic [44, (Fig. 2A), abdominal [15,18,30,41,45,[50][51][52][53][54][55][56]60,[62][63][64]66,70,73,74,[76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94] (Fig. 2B), spinal [43,46,48,63,82, (Fig.…”

“…Five studies reported on delineation variability in pediatric cases [41,[133][134][135][136], of which the results are summarized in Table 4. One study included both thoracic and abdominal target volumes [134], and four studies included abdominal target volumes [41,133,135,136].…”