Protocolised way to cope with anatomical changes in head & neck cancer during the course of radiotherapy
| Autor: | Suzanne van Beek, Jeroen B. van de Kamer, Olga Hamming-Vrieze, Peter Remeijer, Abrahim Al-Mamgani, Arash Navran, Marcel C.J. Jonker |
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| Rok vydání: | 2019 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty lcsh:R895-920 medicine.medical_treatment IGART in treatment delivery Planning target volume Subgroup analysis Head neck cancer urologic and male genital diseases lcsh:RC254-282 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine stomatognathic system Anatomical changes medicine Radiology Nuclear Medicine and imaging In patient Head and neck cancer Cone beam CT Care Planning Cone beam ct Oncology (nursing) business.industry Health Policy respiratory system lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens equipment and supplies Adaptive delivery medicine.disease Radiation therapy Image guided radiotherapy Traffic light protocol 030220 oncology & carcinogenesis sense organs Radiology business Chemoradiotherapy |
| Zdroj: | Technical Innovations & Patient Support in Radiation Oncology Technical Innovations & Patient Support in Radiation Oncology, Vol 12, Iss, Pp 34-40 (2019) |
| ISSN: | 2405-6324 |
| DOI: | 10.1016/j.tipsro.2019.11.001 |
| Popis: | Highlights • Protocolised evaluation of daily CBCT by RTTs result in re-planning in 10%. • Patients treated with chemoradiotherapy have the highest probability of requiring re-planning. • Most anatomical changes visible on CBCT were detected in treatment week 2, 3 and 4. Introduction During a course of radiotherapy for head-and-neck-cancer (HNC), non-rigid anatomical changes can be observed on daily Cone Beam CT (CBCT). To objectify responses to these changes, we use a decision support system (traffic light protocol). Action levels orange and red may lead to re-planning. The purpose of this study was to evaluate how often re-planning was done for non-rigid anatomical changes, which anatomical changes led to re-planning and in which subgroups of patients treatment adaptation was deemed necessary. Materials and methods A consecutive series of 388 HNC patients were retrospectively selected using the digital log of CBCT scans. The logs were analyzed for the number of new plans on an original planning CT scan (O-pCT) or a new pCT scan (N-pCT). Reasons for re-planning were categorized into: target volume increase/decrease, body contour decrease/increase and local shift of target volume. Subgroup analysis was performed to investigate relative differences of re-planning between treatment modalities. Results For 33 patients the treatment plan was adapted due to anatomical changes, resulting in 37 new plans in total. Re-planning on a N-pCT with complete re-delineation was done 22 times. In fifteen cases a new plan was created after adjustment of contours on the O-pCT. Main reasons for re-planning were target volume increase, body contour decrease and local shifts of target volume. Most re-planning (23%) was seen in patients treated with chemoradiotherapy. Conclusion Visual detection of anatomical changes on CBCT during treatment of HNC, results in re-planning in 1 out of 10 patients. |
| Databáze: | OpenAIRE |
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