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Radiotherapy in oncological emergencies: fast-track treatment planning

BACKGROUND AND PURPOSE: To report on our clinical experience with a newly implemented workflow for radiotherapy (RT) emergency treatments, which allows for a fast treatment application outside the regular working-hours, and its clinical applicability. METHODS: Treatment planning of 18 emergency RT p...

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Autores principales: Nierer, Lukas, Walter, Franziska, Niyazi, Maximilian, Shpani, Roel, Landry, Guillaume, Marschner, Sebastian, von Bestenbostel, Rieke, Dinkel, Dominika, Essenbach, Gabriela, Reiner, Michael, Belka, Claus, Corradini, Stefanie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488151/
https://www.ncbi.nlm.nih.gov/pubmed/32912293
http://dx.doi.org/10.1186/s13014-020-01657-6
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author Nierer, Lukas
Walter, Franziska
Niyazi, Maximilian
Shpani, Roel
Landry, Guillaume
Marschner, Sebastian
von Bestenbostel, Rieke
Dinkel, Dominika
Essenbach, Gabriela
Reiner, Michael
Belka, Claus
Corradini, Stefanie
author_facet Nierer, Lukas
Walter, Franziska
Niyazi, Maximilian
Shpani, Roel
Landry, Guillaume
Marschner, Sebastian
von Bestenbostel, Rieke
Dinkel, Dominika
Essenbach, Gabriela
Reiner, Michael
Belka, Claus
Corradini, Stefanie
author_sort Nierer, Lukas
collection PubMed
description BACKGROUND AND PURPOSE: To report on our clinical experience with a newly implemented workflow for radiotherapy (RT) emergency treatments, which allows for a fast treatment application outside the regular working-hours, and its clinical applicability. METHODS: Treatment planning of 18 emergency RT patients was carried out using diagnostic computed tomography (CT) without a dedicated RT simulation CT. The cone-beam CT (CBCT) deviations of the first RT treatment were analyzed regarding setup accuracy. Furthermore, feasibility of the “fast-track” workflow was evaluated with respect to dose deviations caused by different Hounsfield unit (HU) to relative electron density (rED) calibrations and RT treatment couch surface shapes via 3D gamma index analysis of exemplary treatment plans. The dosimetric uncertainty introduced by different CT calibrations was quantified. RESULTS: Mean patient setup vs. CBCT isocenter deviations were (0.49 ± 0.44) cm (x), (2.68 ± 1.63) cm (y) and (1.80 ± 1.06) cm (z) for lateral, longitudinal and vertical directions, respectively. Three out of four dose comparisons between the emergency RT plan calculated on the diagnostic CT and the same plan calculated on the treatment planning CT showed clinically acceptable gamma passing rates, when correcting for surface artifacts. The maximum difference of rED was 0.054, while most parts of the CT calibration curves coincided well. CONCLUSION: In an emergency RT setting, the use of diagnostic CT data for treatment planning might be time-saving and was shown to be suitable for many cases, considering reproducibility of patient setup, accuracy of initial patient setup and accuracy of dose-calculation.
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spelling pubmed-74881512020-09-16 Radiotherapy in oncological emergencies: fast-track treatment planning Nierer, Lukas Walter, Franziska Niyazi, Maximilian Shpani, Roel Landry, Guillaume Marschner, Sebastian von Bestenbostel, Rieke Dinkel, Dominika Essenbach, Gabriela Reiner, Michael Belka, Claus Corradini, Stefanie Radiat Oncol Research BACKGROUND AND PURPOSE: To report on our clinical experience with a newly implemented workflow for radiotherapy (RT) emergency treatments, which allows for a fast treatment application outside the regular working-hours, and its clinical applicability. METHODS: Treatment planning of 18 emergency RT patients was carried out using diagnostic computed tomography (CT) without a dedicated RT simulation CT. The cone-beam CT (CBCT) deviations of the first RT treatment were analyzed regarding setup accuracy. Furthermore, feasibility of the “fast-track” workflow was evaluated with respect to dose deviations caused by different Hounsfield unit (HU) to relative electron density (rED) calibrations and RT treatment couch surface shapes via 3D gamma index analysis of exemplary treatment plans. The dosimetric uncertainty introduced by different CT calibrations was quantified. RESULTS: Mean patient setup vs. CBCT isocenter deviations were (0.49 ± 0.44) cm (x), (2.68 ± 1.63) cm (y) and (1.80 ± 1.06) cm (z) for lateral, longitudinal and vertical directions, respectively. Three out of four dose comparisons between the emergency RT plan calculated on the diagnostic CT and the same plan calculated on the treatment planning CT showed clinically acceptable gamma passing rates, when correcting for surface artifacts. The maximum difference of rED was 0.054, while most parts of the CT calibration curves coincided well. CONCLUSION: In an emergency RT setting, the use of diagnostic CT data for treatment planning might be time-saving and was shown to be suitable for many cases, considering reproducibility of patient setup, accuracy of initial patient setup and accuracy of dose-calculation. BioMed Central 2020-09-10 /pmc/articles/PMC7488151/ /pubmed/32912293 http://dx.doi.org/10.1186/s13014-020-01657-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Nierer, Lukas
Walter, Franziska
Niyazi, Maximilian
Shpani, Roel
Landry, Guillaume
Marschner, Sebastian
von Bestenbostel, Rieke
Dinkel, Dominika
Essenbach, Gabriela
Reiner, Michael
Belka, Claus
Corradini, Stefanie
Radiotherapy in oncological emergencies: fast-track treatment planning
title Radiotherapy in oncological emergencies: fast-track treatment planning
title_full Radiotherapy in oncological emergencies: fast-track treatment planning
title_fullStr Radiotherapy in oncological emergencies: fast-track treatment planning
title_full_unstemmed Radiotherapy in oncological emergencies: fast-track treatment planning
title_short Radiotherapy in oncological emergencies: fast-track treatment planning
title_sort radiotherapy in oncological emergencies: fast-track treatment planning
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488151/
https://www.ncbi.nlm.nih.gov/pubmed/32912293
http://dx.doi.org/10.1186/s13014-020-01657-6
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