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Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method
In patients with pancreatic cancer, intensity‐modulated radiotherapy (IMRT) under breath holding facilitates concentration of the radiation dose in the tumor, while sparing the neighboring organs at risk and minimizing interplay effects between movement of the multileaf collimator and motion of the...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714573/ https://www.ncbi.nlm.nih.gov/pubmed/24036858 http://dx.doi.org/10.1120/jacmp.v14i5.4252 |
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author | Takakura, Toru Nakamura, Mitsuhiro Shibuya, Keiko Nakata, Manabu Nakamura, Akira Yukinori, Matsuo Shiinoki, Takeshi Higashimura, Kyoji Teshima, Teruki Hiraoka, Masahiro |
author_facet | Takakura, Toru Nakamura, Mitsuhiro Shibuya, Keiko Nakata, Manabu Nakamura, Akira Yukinori, Matsuo Shiinoki, Takeshi Higashimura, Kyoji Teshima, Teruki Hiraoka, Masahiro |
author_sort | Takakura, Toru |
collection | PubMed |
description | In patients with pancreatic cancer, intensity‐modulated radiotherapy (IMRT) under breath holding facilitates concentration of the radiation dose in the tumor, while sparing the neighboring organs at risk and minimizing interplay effects between movement of the multileaf collimator and motion of the internal structures. Although the breath‐holding technique provides high interportal reproducibility of target position, dosimetric errors caused by interportal breath‐holding positional error have not been reported. Here, we investigated the effects of interportal breath‐holding positional errors on IMRT dose distribution by incorporating interportal positional error into the original treatment plan, using random numbers in ten patients treated for pancreatic cancer. We also developed a treatment planning technique that shortens breath‐holding time without increasing dosimetric quality assurance workload. The key feature of our proposed method is performance of dose calculation using the same optimized fluence map as the original plan, after dose per fraction in the original plan was cut in half and the number of fractions was doubled. Results confirmed that interportal error had a negligible effect on dose distribution over multiple fractions. Variations in the homogeneity index and the dose delivered to 98%, 2%, and 50% of the volume for the planning target volume, and the dose delivered to 1 cc of the volume for the duodenum and stomach were [Formula: see text] , on average, in comparison with the original plan. The new treatment planning method decreased breath‐holding time by 33%, and differences in dose‐volume metrics between the original and the new treatment plans were within [Formula: see text]. An additional advantage of our proposed method is that interportal errors can be better averaged out; thus, dose distribution in the proposed method may be closer to the planned dose distribution than with the original plans. PACS number: 87.53.Bn, 87.55.D‐, 87.55.‐x |
format | Online Article Text |
id | pubmed-5714573 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-57145732018-04-02 Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method Takakura, Toru Nakamura, Mitsuhiro Shibuya, Keiko Nakata, Manabu Nakamura, Akira Yukinori, Matsuo Shiinoki, Takeshi Higashimura, Kyoji Teshima, Teruki Hiraoka, Masahiro J Appl Clin Med Phys Radiation Oncology Physics In patients with pancreatic cancer, intensity‐modulated radiotherapy (IMRT) under breath holding facilitates concentration of the radiation dose in the tumor, while sparing the neighboring organs at risk and minimizing interplay effects between movement of the multileaf collimator and motion of the internal structures. Although the breath‐holding technique provides high interportal reproducibility of target position, dosimetric errors caused by interportal breath‐holding positional error have not been reported. Here, we investigated the effects of interportal breath‐holding positional errors on IMRT dose distribution by incorporating interportal positional error into the original treatment plan, using random numbers in ten patients treated for pancreatic cancer. We also developed a treatment planning technique that shortens breath‐holding time without increasing dosimetric quality assurance workload. The key feature of our proposed method is performance of dose calculation using the same optimized fluence map as the original plan, after dose per fraction in the original plan was cut in half and the number of fractions was doubled. Results confirmed that interportal error had a negligible effect on dose distribution over multiple fractions. Variations in the homogeneity index and the dose delivered to 98%, 2%, and 50% of the volume for the planning target volume, and the dose delivered to 1 cc of the volume for the duodenum and stomach were [Formula: see text] , on average, in comparison with the original plan. The new treatment planning method decreased breath‐holding time by 33%, and differences in dose‐volume metrics between the original and the new treatment plans were within [Formula: see text]. An additional advantage of our proposed method is that interportal errors can be better averaged out; thus, dose distribution in the proposed method may be closer to the planned dose distribution than with the original plans. PACS number: 87.53.Bn, 87.55.D‐, 87.55.‐x John Wiley and Sons Inc. 2013-09-06 /pmc/articles/PMC5714573/ /pubmed/24036858 http://dx.doi.org/10.1120/jacmp.v14i5.4252 Text en © 2013 The Authors. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Radiation Oncology Physics Takakura, Toru Nakamura, Mitsuhiro Shibuya, Keiko Nakata, Manabu Nakamura, Akira Yukinori, Matsuo Shiinoki, Takeshi Higashimura, Kyoji Teshima, Teruki Hiraoka, Masahiro Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
title | Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
title_full | Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
title_fullStr | Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
title_full_unstemmed | Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
title_short | Effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
title_sort | effects of interportal error on dose distribution in patients undergoing breath‐holding intensity‐modulated radiotherapy for pancreatic cancer: evaluation of a new treatment planning method |
topic | Radiation Oncology Physics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5714573/ https://www.ncbi.nlm.nih.gov/pubmed/24036858 http://dx.doi.org/10.1120/jacmp.v14i5.4252 |
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