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  4. Surface Guided Radiotherapy Decreases the Uncertainty in Breast Cancer Patient Setup

Surface Guided Radiotherapy Decreases the Uncertainty in Breast Cancer Patient Setup

S Ceberg1*, A Mannerberg2 , L Berg3 , A Edvardsson4 , C Thornberg5 , S Alkner6 , M Kugele7 , (1) Medical Radiation Physics, Department of clinical sciences, Lund University, and Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden (2) Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden (3) Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden (4) Medical Radiation Physics, Department of clinical sciences, Lund University, Sweden (5) Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden (6) Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden (7) Medical Radiation Physics, Department of clinical sciences, Lund University, and Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund, Sweden

Presentations

(Sunday, 7/29/2018) 3:00 PM - 6:00 PM

Room: Exhibit Hall

Purpose: The aim was to investigate if the setup of breast cancer patients could be improved using surface guided radiotherapy, compared to the conventional method using lasers and skin markings.

Methods: Forty-seven patients, who received tangential or locoregional adjuvant radiotherapy, were positioned using a surface-based setup (SBS). Thirty-eight patients were positioned using the conventional laser-based setup (LBS). For the patient group positioned using a SBS, correction for posture was performed under guidance of a color map projected onto the patients' skin in real time. The surface tolerance for the color map was 5 mm. For both setup techniques the deviation of the breast position was measured using verification images. In total, 897 images were analysed. The frequency distributions of the deviations were analysed.

Results: The result showed a significant improvement in the interfractional variation of the setup deviation for SBS compared to the LBS (p<0.01), both for the tangential and the locoregional treatments.For patients who received tangential treatments, the percentage number of fractions where the setup deviation exceeded 4 mm in any direction, which is the threshold for online correction used in the clinic, were 16.2% for LBS and 4.6% for SBS. For patients who received locoregional treatments, the percentage number of fractions where the setup deviation exceeded 4 mm was 44%/31%/36% (in the vrt/lng/lat directions) for LBS and 7.5%/7.5%/27% for SBS.

Conclusion: Conventional laser-based setup can be replaced by surface-based setup, both for tangential and locoregional breast cancer treatments.

Funding Support, Disclosures, and Conflict of Interest: Declaration of interest: Our research is partly financially supported by C-RAD AB, Uppsala, Sweden, however, the authors alone are responsible for the content, analyses, and writing.

Keywords

Breast, Image-guided Therapy, Setup Verification

Taxonomy

TH- RT Interfraction motion management : setup errors, immobilization, localization

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