Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with...Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory(MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale(SAS), State-Trait Anxiety Inventory(STAI), and Anxiety Sensitivity Index(ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph(DRR). Patients completed the assessment at three time points: before the initial radiotherapy(T1), before the middle radiotherapy(T2), and before the last radiotherapy(T3).Results: The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3(F=24.44, P<0.001;F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1(Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1(B=0.458, P<0.05).Conclusions: This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.展开更多
Objective: We aim to quantify the magnitude of setup errors in intensity-modulated radiotherapy (IMRT) treated Head and Neck cancer patients and recommend appropriate PTV margin. Methods: 60 patients with head and nec...Objective: We aim to quantify the magnitude of setup errors in intensity-modulated radiotherapy (IMRT) treated Head and Neck cancer patients and recommend appropriate PTV margin. Methods: 60 patients with head and neck cancer required bilateral neck irradiation were planned and treated by simultaneous integrated boost IMRT technique either treated radically or postoperative. Patients undergoing image-guided radiotherapy (IGRT) each with once weekly scheduled cone beam computed tomography (CBCT). The 3D displacements, systematic and random errors were calculated. The appropriate PTV expansion was determined using Van Herk’s formula. Results: Mean 3D displacement was 0.16 cm in the vertical direction, 0.14 cm in the horizontal direction and 0.16 cm in the longitudinal direction. Conclusion: Use of weekly CBCT allows the planning target volume (PTV) expansion to be reduced according to our setup. The appropriate clinical target volume (CTV)-PTV margin for our institute is 0.30 cm, 0.38 cm, and 0.33 cm in the horizontal, vertical, and longitudinal directions, respectively.展开更多
Purpose: To investigate the feasibility of applying ANOVA newly proposed by Yukinori to verify the setup errors, PTV (Planning Target Volume) margins, DVH for lung cancer with SBRT. Methods: 20 patients receiving SBRT...Purpose: To investigate the feasibility of applying ANOVA newly proposed by Yukinori to verify the setup errors, PTV (Planning Target Volume) margins, DVH for lung cancer with SBRT. Methods: 20 patients receiving SBRT to 50 Gy in 5 fractions with a Varian iX linear acceleration were selected. Each patient was scanned with kV-CBCT before the daily treatment to verify the setup position. Two other error calculation methods raised by Van Herk and Remeijer were also compared to discover the statistical difference in systematic errors (Σ), random errors (σ), PTV margins and DVH. Results: Utilizing two PTV margin calculation formulas (Stroom, Van Herk), PTV calculated by Yukinori method in three directions were (5.89 and 3.95), (5.54 and 3.55), (3.24 and 0.78) mm;Van Herk method were (6.10 and 4.25), (5.73 and 3.83), (3.51 and 1.13) mm;Remeijer method were (6.39 and 4.57), (5.98 and 4.10), (3.69 and 1.33) mm. The volumes of PTV using Yukinori method were significantly smaller (P < 0.05) than Van Herk method and Remeijer method. However, dosimetric indices of PTV (D98, D50, D2) and for OARs (Mean Dose, V20, V5) had no significant difference (P > 0.05) among three methods. Conclusions: In lung SBRT treatment, due to fraction reduction and high level of dose per fraction, ANOVA was able to offset the effect of random factors in systematic errors, reducing the PTV margins and volumes. However, no distinct dose distribution improvement was founded in target volume and organs at risk.展开更多
Objective： The aim of this work was to quantify the extent of set-up errors to conduct a quality assurance （QA） aspect of treatment delivery, verification of the treatment field＇s position on different days using ...Objective： The aim of this work was to quantify the extent of set-up errors to conduct a quality assurance （QA） aspect of treatment delivery, verification of the treatment field＇s position on different days using electronic portal. Methods： This study was carried out on 12 patients, treated for pelvis tumor; and total of 240 images obtained by electronic portal image device （EPID） were analyzed. The EPIs acquire using EPID attached to the Siemens linear accelerator. The anatomy match- ing software （Theraview） was used and displacement in two dimensions were noted for each treatment field to study patient setup errors. Results： The percentages of mean deviations less than 5 mm in X direction were 65% ＆ 92%, from 5-10 mm were 31% ＆ 19% and more than 10 mm were 11% ＆ 9% forNP and lateral direction respectively. The percentages of mean deviations less than 5 mm in Y direction were 65% ＆ 63%, from 5-10 mm were 33% ＆ 28% and more than 10 mm were 22% ＆ 29%. The mean deviations in 2D-vector errors were 〈 5 mm in 47% and 46%, 5-10 mm in 36% and 37% and 〉 10 mm in 37% and 37% of images in the NP and lateral direction respectively. Conclusion： The results revealed that the ranges of set up errors are immobilization method to improve reproducibility. The observed variations were not within the limits..展开更多
文摘Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory(MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale(SAS), State-Trait Anxiety Inventory(STAI), and Anxiety Sensitivity Index(ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph(DRR). Patients completed the assessment at three time points: before the initial radiotherapy(T1), before the middle radiotherapy(T2), and before the last radiotherapy(T3).Results: The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3(F=24.44, P<0.001;F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1(Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1(B=0.458, P<0.05).Conclusions: This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.
文摘Objective: We aim to quantify the magnitude of setup errors in intensity-modulated radiotherapy (IMRT) treated Head and Neck cancer patients and recommend appropriate PTV margin. Methods: 60 patients with head and neck cancer required bilateral neck irradiation were planned and treated by simultaneous integrated boost IMRT technique either treated radically or postoperative. Patients undergoing image-guided radiotherapy (IGRT) each with once weekly scheduled cone beam computed tomography (CBCT). The 3D displacements, systematic and random errors were calculated. The appropriate PTV expansion was determined using Van Herk’s formula. Results: Mean 3D displacement was 0.16 cm in the vertical direction, 0.14 cm in the horizontal direction and 0.16 cm in the longitudinal direction. Conclusion: Use of weekly CBCT allows the planning target volume (PTV) expansion to be reduced according to our setup. The appropriate clinical target volume (CTV)-PTV margin for our institute is 0.30 cm, 0.38 cm, and 0.33 cm in the horizontal, vertical, and longitudinal directions, respectively.
文摘Purpose: To investigate the feasibility of applying ANOVA newly proposed by Yukinori to verify the setup errors, PTV (Planning Target Volume) margins, DVH for lung cancer with SBRT. Methods: 20 patients receiving SBRT to 50 Gy in 5 fractions with a Varian iX linear acceleration were selected. Each patient was scanned with kV-CBCT before the daily treatment to verify the setup position. Two other error calculation methods raised by Van Herk and Remeijer were also compared to discover the statistical difference in systematic errors (Σ), random errors (σ), PTV margins and DVH. Results: Utilizing two PTV margin calculation formulas (Stroom, Van Herk), PTV calculated by Yukinori method in three directions were (5.89 and 3.95), (5.54 and 3.55), (3.24 and 0.78) mm;Van Herk method were (6.10 and 4.25), (5.73 and 3.83), (3.51 and 1.13) mm;Remeijer method were (6.39 and 4.57), (5.98 and 4.10), (3.69 and 1.33) mm. The volumes of PTV using Yukinori method were significantly smaller (P < 0.05) than Van Herk method and Remeijer method. However, dosimetric indices of PTV (D98, D50, D2) and for OARs (Mean Dose, V20, V5) had no significant difference (P > 0.05) among three methods. Conclusions: In lung SBRT treatment, due to fraction reduction and high level of dose per fraction, ANOVA was able to offset the effect of random factors in systematic errors, reducing the PTV margins and volumes. However, no distinct dose distribution improvement was founded in target volume and organs at risk.
文摘Objective： The aim of this work was to quantify the extent of set-up errors to conduct a quality assurance （QA） aspect of treatment delivery, verification of the treatment field＇s position on different days using electronic portal. Methods： This study was carried out on 12 patients, treated for pelvis tumor; and total of 240 images obtained by electronic portal image device （EPID） were analyzed. The EPIs acquire using EPID attached to the Siemens linear accelerator. The anatomy match- ing software （Theraview） was used and displacement in two dimensions were noted for each treatment field to study patient setup errors. Results： The percentages of mean deviations less than 5 mm in X direction were 65% ＆ 92%, from 5-10 mm were 31% ＆ 19% and more than 10 mm were 11% ＆ 9% forNP and lateral direction respectively. The percentages of mean deviations less than 5 mm in Y direction were 65% ＆ 63%, from 5-10 mm were 33% ＆ 28% and more than 10 mm were 22% ＆ 29%. The mean deviations in 2D-vector errors were 〈 5 mm in 47% and 46%, 5-10 mm in 36% and 37% and 〉 10 mm in 37% and 37% of images in the NP and lateral direction respectively. Conclusion： The results revealed that the ranges of set up errors are immobilization method to improve reproducibility. The observed variations were not within the limits..
