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Strahlentherapie und Onkologie

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Open Access 04-07-2022 | Digital Volume Tomography | Original Article

Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients

Authors: Tim-Oliver Sauer, Oliver J. Ott, Godehard Lahmer, Rainer Fietkau, Christoph Bert

Published in: Strahlentherapie und Onkologie | Issue 1/2023

Abstract

Purpose

A markerless workflow for the treatment of breast cancer patients has been introduced and evaluated retrospectively. It includes surface-guided radiation therapy (SGRT)-only positioning for patients with small cone beam CT (CBCT) position corrections during the first five fractions. Prerequisites and the frequency of its clinical application were evaluated, as well as potential benefits in terms of treatment time and dose savings, the frequency of CBCT scans, and the accuracy of the positioning.

Methods

A group of 100 patients treated with the new workflow on two Versa HD linacs has been compared to a matched control group of patients treated with the former workflow, which included prepositioning with skin markings and lasers, SGRT and daily CBCT. The comparison was based on the evaluation of logfiles.

Results

Of the patients treated with the new workflow, 40% did not receive daily CBCT scans. This resulted in mean time savings of 97 s, 166 s and 239 s per fraction for the new workflow, for patients treated without daily CBCT and for SGRT-only fractions, respectively, when compared to the old workflow. Dose savings amounted to a weighted computed tomography dose index reduction of CTDI_W = 2.56 cGy on average for normofractionated treatment and weekly CBCTs, while for patients not treated with daily CBCT, SGRT-based positioning accuracy was 5.2 mm for the mean translational magnitude, as evaluated by CBCT.

Conclusion

For 40% of the patients, after five fractions with small CBCT corrections, the workflow could be changed to SGRT-only positioning with weekly CBCT. This leads to imaging dose and time savings and thus also reduced intrafraction motion, potentially increased patient throughput and patient comfort, while assuring appropriate positioning accuracy.

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Title: Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients
Authors: Tim-Oliver Sauer
Oliver J. Ott
Godehard Lahmer
Rainer Fietkau
Christoph Bert
Publication date: 04-07-2022
Publisher: Springer Berlin Heidelberg
Keywords: Digital Volume Tomography
Breast Cancer
Breast Cancer
Digital Volume Tomography
Laser
Published in: Strahlentherapie und Onkologie / Issue 1/2023
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-01966-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prerequisites for the clinical implementation of a markerless SGRT-only workflow for the treatment of breast cancer patients

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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