Cargando…

Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme

OBJECTIVES: Image-guided radiotherapy maximizes therapeutic index of brain irradiation by reducing setup errors during treatment. The aim of study was to analyze setup errors in the radiation treatment of glioblastoma multiforme and if decrease in planning target volume (PTV), margin is feasible usi...

Descripción completa

Detalles Bibliográficos
Autores principales: Pruthi, Deep Shankar, Nagpal, Puneet, Pandey, Manish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943941/
https://www.ncbi.nlm.nih.gov/pubmed/36891114
http://dx.doi.org/10.25259/JNRP_2_2022
_version_ 1784891809049083904
author Pruthi, Deep Shankar
Nagpal, Puneet
Pandey, Manish
author_facet Pruthi, Deep Shankar
Nagpal, Puneet
Pandey, Manish
author_sort Pruthi, Deep Shankar
collection PubMed
description OBJECTIVES: Image-guided radiotherapy maximizes therapeutic index of brain irradiation by reducing setup errors during treatment. The aim of study was to analyze setup errors in the radiation treatment of glioblastoma multiforme and if decrease in planning target volume (PTV), margin is feasible using daily cone beam CT (CBCT) and 6D couch correction. MATERIALS AND METHODS: Twenty-one patients (630 fractions of radiotherapy) were studied in which corrections were made in 6° of freedom. We determined setup errors, impact of setup errors of initial three fractions CBCT versus rest of the treatment with daily CBCT, and mean difference in setup errors with or without application of 6D couch and volumetric benefit of reduction of PTV margin from 0.5 cm to 0.3 cm. RESULTS: The mean shift in the conventional directions, namely, vertical, longitudinal, and lateral was 0.17 cm, 0.19 cm, and 0.11 cm. There was significant change in vertical shift when first three fractions were compared with rest of the treatment with daily CBCT. When the effect of 6D couch was nullified, all directions showed increased error with longitudinal shift being significant. The number of setup errors of magnitude >0.3 cm was more significant when only conventional shifts were applied as compared with 6D couch. There was significant decrease in volume of brain parenchyma irradiated when margin of PTV was reduced from 0.5 cm to 0.3 cm. CONCLUSION: Daily CBCT along with 6D couch correction can reduce setup error which allows reduction in PTV margin during radiotherapy planning in turn improving the therapeutic index.
format Online
Article
Text
id pubmed-9943941
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Scientific Scholar
record_format MEDLINE/PubMed
spelling pubmed-99439412023-03-07 Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme Pruthi, Deep Shankar Nagpal, Puneet Pandey, Manish J Neurosci Rural Pract Original Article OBJECTIVES: Image-guided radiotherapy maximizes therapeutic index of brain irradiation by reducing setup errors during treatment. The aim of study was to analyze setup errors in the radiation treatment of glioblastoma multiforme and if decrease in planning target volume (PTV), margin is feasible using daily cone beam CT (CBCT) and 6D couch correction. MATERIALS AND METHODS: Twenty-one patients (630 fractions of radiotherapy) were studied in which corrections were made in 6° of freedom. We determined setup errors, impact of setup errors of initial three fractions CBCT versus rest of the treatment with daily CBCT, and mean difference in setup errors with or without application of 6D couch and volumetric benefit of reduction of PTV margin from 0.5 cm to 0.3 cm. RESULTS: The mean shift in the conventional directions, namely, vertical, longitudinal, and lateral was 0.17 cm, 0.19 cm, and 0.11 cm. There was significant change in vertical shift when first three fractions were compared with rest of the treatment with daily CBCT. When the effect of 6D couch was nullified, all directions showed increased error with longitudinal shift being significant. The number of setup errors of magnitude >0.3 cm was more significant when only conventional shifts were applied as compared with 6D couch. There was significant decrease in volume of brain parenchyma irradiated when margin of PTV was reduced from 0.5 cm to 0.3 cm. CONCLUSION: Daily CBCT along with 6D couch correction can reduce setup error which allows reduction in PTV margin during radiotherapy planning in turn improving the therapeutic index. Scientific Scholar 2023-01-27 2023 /pmc/articles/PMC9943941/ /pubmed/36891114 http://dx.doi.org/10.25259/JNRP_2_2022 Text en © 2023 Published by Scientific Scholar on behalf of Journal of Neurosciences in Rural Practice https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pruthi, Deep Shankar
Nagpal, Puneet
Pandey, Manish
Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme
title Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme
title_full Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme
title_fullStr Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme
title_full_unstemmed Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme
title_short Effectiveness of 6D couch with daily cone beam computed tomography in reducing PTV margins for glioblastoma multiforme
title_sort effectiveness of 6d couch with daily cone beam computed tomography in reducing ptv margins for glioblastoma multiforme
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943941/
https://www.ncbi.nlm.nih.gov/pubmed/36891114
http://dx.doi.org/10.25259/JNRP_2_2022
work_keys_str_mv AT pruthideepshankar effectivenessof6dcouchwithdailyconebeamcomputedtomographyinreducingptvmarginsforglioblastomamultiforme
AT nagpalpuneet effectivenessof6dcouchwithdailyconebeamcomputedtomographyinreducingptvmarginsforglioblastomamultiforme
AT pandeymanish effectivenessof6dcouchwithdailyconebeamcomputedtomographyinreducingptvmarginsforglioblastomamultiforme