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Radiation Oncology
Published in: Radiation Oncology 1/2014

Open Access 01-12-2014 | Research

Impact of body-mass factors on setup displacement in patients with head and neck cancer treated with radiotherapy using daily on-line image guidance

Authors: Yo-Liang Lai, Shih-Neng Yang, Ji-An Liang, Yao-Ching Wang, Chun-Yen Yu, Ching-Hsiung Su, Shang-Wen Chen

Published in: Radiation Oncology | Issue 1/2014

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Abstract

Background

To determine the impact of body-mass factors (BMF) before radiotherapy and changes during radiotherapy on the magnitude of setup displacement in patients with head and neck cancer (HNC).

Methods

The clinical data of 30 patients with HNC was analyzed using the alignment data from daily on-line on-board imaging from image-guided radiotherapy. BMFs included body weight, body height, and the circumference and bilateral thickness of the neck. Changes in the BMFs during treatment were retrieved from cone beam computed tomography at the 10th and 20th fractions. Setup errors for each patient were assessed by systematic error (SE) and random error (RE) through the superior-inferior (SI), anterior-posterior (AP), and medial-lateral (ML) directions, and couch rotation (CR). Using the median values of the BMFs as a cutoff, the impact of the factors on the magnitude of displacement was assessed by the Mann–Whitney U test.

Results

A higher body weight before radiotherapy correlated with a greater AP-SE (p = 0.045), SI-RE (p = 0.023), and CR-SE (p = 0.033). A longer body height was associated with a greater SI-RE (p = 0.002). A performance status score of 1 or 2 was related to a greater AP-SE (p = 0.043), AP-RE (p = 0.015), and SI-RE (p = 0.043). Among the ratios of the BMFs during radiotherapy, the values at the level of mastoid tip at the 20th fraction were associated with greater setup errors.

Conclusions

To reduce setup errors in patients with HNC receiving RT, the use of on-line image-guided radiotherapy is recommended for patients with a large body weight or height, and a performance status score of 1–2. In addition, adaptive planning should be considered for those who have a large reduction ratio in the circumference (<1) and thickness (<0.94) over the level of the mastoid tip during the 20th fraction of treatment.
Appendix
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Metadata
Title
Impact of body-mass factors on setup displacement in patients with head and neck cancer treated with radiotherapy using daily on-line image guidance
Authors
Yo-Liang Lai
Shih-Neng Yang
Ji-An Liang
Yao-Ching Wang
Chun-Yen Yu
Ching-Hsiung Su
Shang-Wen Chen
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-9-19

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