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Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients
PURPOSE: A markerless workflow for the treatment of breast cancer patients has been introduced and evaluated retrospectively. It includes surface-guided radiation therapy (SGRT)-only positioning for patients with small cone beam CT (CBCT) position corrections during the first five fractions. Prerequ...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839804/ https://www.ncbi.nlm.nih.gov/pubmed/35788694 http://dx.doi.org/10.1007/s00066-022-01966-7 |
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author | Sauer, Tim-Oliver Ott, Oliver J. Lahmer, Godehard Fietkau, Rainer Bert, Christoph |
author_facet | Sauer, Tim-Oliver Ott, Oliver J. Lahmer, Godehard Fietkau, Rainer Bert, Christoph |
author_sort | Sauer, Tim-Oliver |
collection | PubMed |
description | PURPOSE: A markerless workflow for the treatment of breast cancer patients has been introduced and evaluated retrospectively. It includes surface-guided radiation therapy (SGRT)-only positioning for patients with small cone beam CT (CBCT) position corrections during the first five fractions. Prerequisites and the frequency of its clinical application were evaluated, as well as potential benefits in terms of treatment time and dose savings, the frequency of CBCT scans, and the accuracy of the positioning. METHODS: A group of 100 patients treated with the new workflow on two Versa HD linacs has been compared to a matched control group of patients treated with the former workflow, which included prepositioning with skin markings and lasers, SGRT and daily CBCT. The comparison was based on the evaluation of logfiles. RESULTS: Of the patients treated with the new workflow, 40% did not receive daily CBCT scans. This resulted in mean time savings of 97 s, 166 s and 239 s per fraction for the new workflow, for patients treated without daily CBCT and for SGRT-only fractions, respectively, when compared to the old workflow. Dose savings amounted to a weighted computed tomography dose index reduction of CTDI(W) = 2.56 cGy on average for normofractionated treatment and weekly CBCTs, while for patients not treated with daily CBCT, SGRT-based positioning accuracy was 5.2 mm for the mean translational magnitude, as evaluated by CBCT. CONCLUSION: For 40% of the patients, after five fractions with small CBCT corrections, the workflow could be changed to SGRT-only positioning with weekly CBCT. This leads to imaging dose and time savings and thus also reduced intrafraction motion, potentially increased patient throughput and patient comfort, while assuring appropriate positioning accuracy. |
format | Online Article Text |
id | pubmed-9839804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-98398042023-01-15 Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients Sauer, Tim-Oliver Ott, Oliver J. Lahmer, Godehard Fietkau, Rainer Bert, Christoph Strahlenther Onkol Original Article PURPOSE: A markerless workflow for the treatment of breast cancer patients has been introduced and evaluated retrospectively. It includes surface-guided radiation therapy (SGRT)-only positioning for patients with small cone beam CT (CBCT) position corrections during the first five fractions. Prerequisites and the frequency of its clinical application were evaluated, as well as potential benefits in terms of treatment time and dose savings, the frequency of CBCT scans, and the accuracy of the positioning. METHODS: A group of 100 patients treated with the new workflow on two Versa HD linacs has been compared to a matched control group of patients treated with the former workflow, which included prepositioning with skin markings and lasers, SGRT and daily CBCT. The comparison was based on the evaluation of logfiles. RESULTS: Of the patients treated with the new workflow, 40% did not receive daily CBCT scans. This resulted in mean time savings of 97 s, 166 s and 239 s per fraction for the new workflow, for patients treated without daily CBCT and for SGRT-only fractions, respectively, when compared to the old workflow. Dose savings amounted to a weighted computed tomography dose index reduction of CTDI(W) = 2.56 cGy on average for normofractionated treatment and weekly CBCTs, while for patients not treated with daily CBCT, SGRT-based positioning accuracy was 5.2 mm for the mean translational magnitude, as evaluated by CBCT. CONCLUSION: For 40% of the patients, after five fractions with small CBCT corrections, the workflow could be changed to SGRT-only positioning with weekly CBCT. This leads to imaging dose and time savings and thus also reduced intrafraction motion, potentially increased patient throughput and patient comfort, while assuring appropriate positioning accuracy. Springer Berlin Heidelberg 2022-07-04 2023 /pmc/articles/PMC9839804/ /pubmed/35788694 http://dx.doi.org/10.1007/s00066-022-01966-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This 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/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Sauer, Tim-Oliver Ott, Oliver J. Lahmer, Godehard Fietkau, Rainer Bert, Christoph Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients |
title | Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients |
title_full | Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients |
title_fullStr | Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients |
title_full_unstemmed | Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients |
title_short | Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients |
title_sort | prerequisites for the clinical implementation of a markerless sgrt-only workflow for the treatment of breast cancer patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839804/ https://www.ncbi.nlm.nih.gov/pubmed/35788694 http://dx.doi.org/10.1007/s00066-022-01966-7 |
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