The Dosimetric Effect of Intrafraction Prostate Motion on Step-and-Shoot Intensity-Modulated Radiation Therapy Plans: Magnitude, Correlation With Motion Parameters, and Comparison With Helical Tomotherapy Plans

被引:23
作者
Langen, Katja M. [1 ]
Chauhan, Bhavin [1 ]
Siebers, Jeffrey V. [2 ]
Moore, Joseph [2 ]
Kupelian, Patrick A. [3 ]
机构
[1] MD Anderson Canc Ctr Orlando, Dept Radiat Oncol, Orlando, FL 32806 USA
[2] Virginia Commonwealth Univ, Dept Radiat Oncol, Richmond, VA USA
[3] Univ Calif Los Angeles, Dept Radiat Oncol, Los Angeles, CA 90024 USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2012年 / 84卷 / 05期
关键词
Intensity-modulated radiation therapy; Intrafraction motion; Dosimetry; RADIOTHERAPY; ONLINE; IMRT;
D O I
10.1016/j.ijrobp.2012.01.046
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To determine the daily and cumulative dosimetric effects of intrafraction prostate motion on step-and-shoot (SNS) intensity-modulated radiation therapy (IMRT) plans, to evaluate the correlation of dosimetric effect with motion-based metrics, and to compare on a fraction-by-fraction basis the dosimetric effect induced in SNS and helical tomotherapy plans. Methods and Materials: Intrafraction prostate motion data from 486 fractions and 15 patients were available. A motion-encoded dose calculation technique was used to determine the variation of the clinical target volume (CTV) D-95% values with respect to the static plan for SNS plans. The motion data were analyzed separately, and the correlation coefficients between various motion-based metrics and the dosimetric effect were determined. The dosimetric impact was compared with that incurred during another IMRT technique to assess correlation across different delivery techniques. Results: The mean (+/- 1 standard deviation [SD]) change in D95% in the CTV over all 486 fractions was 0.2 +/- 0.5%. After the delivery of five and 12 fractions, the mean (+/- 1 SD) changes over the 15 patients in CTV D95% were 0.0 +/- 0.2% and 0.1 +/- 0.2%, respectively. The correlation coefficients between the CTV D95% changes and the evaluated motion metrics were, in general, poor and ranged from r = -0.2 to r = -0.39. Dosimetric effects introduced by identical motion in SNS and helical tomotherapy IMRT techniques were poorly correlated with a correlation coefficient of r = 0.32 for the CTV. Conclusions: The dosimetric impact of intrafraction prostate motion on the CTV is, in general, small. In only 4% of all fractions did the dosimetric consequence exceed 1% in the CTV. As expected, the cumulative effect was further reduced with fractionation. The poor correlations between the calculated motion parameters and the subsequent dosimetric effect implies that motion-based thresholds are of limited value in predicting the dosimetric impact of intrafraction motion. The dosimetric effects between the two evaluated delivery techniques were poorly correlated. (C) 2012 Elsevier Inc.
引用
收藏
页码:1220 / 1225
页数:6
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