| Zheng Jiajun,You Hongqiang,Xu Geng,et al.The dosimetric effect of random six-dimensional setup error in intensity-modulated radiotherapy planning for rectal cancer[J].Chinese Journal of Radiological Medicine and Protection,2023,43(11):881-887 |
| The dosimetric effect of random six-dimensional setup error in intensity-modulated radiotherapy planning for rectal cancer |
| Received:May 15, 2023 |
| DOI：10.3760/cma.j.cn112271-20230515-00144 |
| KeyWords:Rectal cancer Intensity modulated radiotherapy 6D setup error ESAPI Dosimetry |
| FundProject:国家重点研发计划项目(2022YFC2404605) |
| Author Name | Affiliation | E-mail | | Zheng Jiajun | Department of Radiation Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing 211103, China | | | You Hongqiang | Department of Radiation Oncology, Affiliated Cancer Hospital of Fuzhou Medical University, Fujian Cancer Hospital, Fuzhou 350014, China
School of Materials Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 211106, China | | | Xu Geng | Department of Radiation Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China | | | Zhai Zhenyu | Department of Radiation Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China | | | He Xia | Department of Radiation Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China | | | Sun Li | Department of Radiation Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China | 13951637370@126.com |
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| Abstract:: |
| Objective To design a method to introduce random six-dimensional setup error (6D-SE) into the intensity-modulated radiotherapy (IMRT) planning for rectal cancer and evaluate its dosimetric effect.Methods A total of 21 IMRT plans for patients with rectal cancer were randomly selected as reference plans [2 Gy per fraction for a total of 50 Gy; a 5 mm uniform margin around the clinical target volume (CTV) was taken as the planning target volume (PTV)]. For each fraction of the reference plan, a randomly generated 6D-SE was introduced by adjusting the geometrical parameters of the radiation field, and the dose was recalculated. The overall dose distribution with 6D-SE was obtained by adding up the dose of each fraction. A treatment simulation program that could complete the above workflow was developed using the Varian Eclipse scripting API (ESAPI). 6D-SEs that obey two preset distributions [distribution 1: translational error obey N(0,42), and rotational error obey N(0,22); distribution 2: translational error obey N(0,22), and rotational error obey N(0,12)] were introduced into the reference plans, and the dosimetric effects were assessed.Results When the reference plans, error distribution 1, and error distribution 2 were applied, the Dmin values of the CTV were (49.4±0.41), (47.56±0.76), and (49.17±0.64) Gy, respectively; the D98% values of the CTV were (50.23±0.07), (49.98±0.10), and (50.27±0.09) Gy, respectively; the D98% values of the primary target area (the kernel part of the target area, excluding the margins) were (50.25±0.08), (50.42±0.13), and (50.33±0.10) Gy, respectively; the D98% values of the marginal area were (50.22±0.10), (49.88±0.11), and (50.26±0.10) Gy, respectively. In addition, compared with the result of the reference plans, the result of errors 1 and 2 showed no significant changes in the mean dose of the bladder and femoral heads (P>0.05), despite slight decreases in the conformity index of the dose distribution with limited clinical significance.Conclusion The proposed method and the treatment simulation program developed thereupon can introduce the 6D-SE obeying different distributions into the IMRT plans for rectal cancer on demand and provide overall dosimetric changes. |
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