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Strahlentherapie und Onkologie

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01-05-2012 | Original article

Risk factors related to interfractional variation in whole pelvic irradiation for locally advanced pelvic malignancies

Authors: W.S. Yoon, D.S. Yang, M.D., Ph.D., J.A. Lee, S. Lee, Y.J. Park, C.Y. Kim

Published in: Strahlentherapie und Onkologie | Issue 5/2012

Abstract

Purpose

The goal of the present study was to demonstrate risk factors affecting the interfractional variation in whole pelvic irradiation.

Patients and methods

Daily image acquisitions of 101 patients with locally advanced pelvic malignancy were undertaken using a kilo-voltage orthogonal on-board imager. The baseline deviation (the shift between the initial treatment and each fraction; Value_Base) and day-to-day variation (the shift between the previous treatment and each fraction; Value_DD) were measured. The standard deviations (SD) along the x- (right–left), y- (cranial–caudal), and z- (anterior–posterior) axes (SD[x], SD[y], and SD[z], respectively), the 3D vector of the SD (SD[3D]), and the mean of 3D shift (mean[3D]) were calculated in each patient. Various clinical factors, lumbar pelvic balance and rotation, and the shift of 5 consecutive fractions from the initial treatment (Value_5Fx) were investigated as risk factors.

Results

The prone set-up showed a larger mean_Base[3D] than in the supine position (p =0 .063). A body mass index (BMI) ≥ 30 kg/m² resulted in the largest mean_DD[3D] (p = 0.078) and SD_DD[3D] (p = 0.058). All the SD_5Fx along the x-, y-, and z-axes had moderate linear relationships with SD_Base and SD_DD (p < 0.001). The SD_5Fx[3D] also had a moderate linear relationship with the mean_Base[3D], mean_DD[3D], SD_Base[3D], and SD_DD[3D] (p < 0.001). In multivariate analysis, the SD_5Fx had the same significant relationship with SD_Base and SD_DD (p < 0.001). A BMI ≥ 30 kg/m² was associated with the largest SD_DD[x] (p = 0.003).

Conclusion

Close surveillance through high-quality and frequent image guidance is recommended for patients with extensive variations of the initial five consecutive fractions or obesity.

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Title: Risk factors related to interfractional variation in whole pelvic irradiation for locally advanced pelvic malignancies
Authors: W.S. Yoon
D.S. Yang, M.D., Ph.D.
J.A. Lee
S. Lee
Y.J. Park
C.Y. Kim
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Strahlentherapie und Onkologie / Issue 5/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0049-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors related to interfractional variation in whole pelvic irradiation for locally advanced pelvic malignancies

Abstract

Purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

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