İsmail Faruk DURMUŞ
(Yeni Yüzyil Üniversitesi Gaziosmanpaşa Hastanesi, Radyasyon Onkolojisi Anabilim Dalı, İstanbul, Türkiye)
Bora TAŞ
(Yeni Yüzyil Üniversitesi Gaziosmanpaşa Hastanesi, Radyasyon Onkolojisi Anabilim Dalı, İstanbul, Türkiye)
Ömer Erol UZEL
(İstanbul Cerrahpaşa Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı, İstanbul, Türkiye)
Yıl: 2020Cilt: 35Sayı: 2ISSN: 1300-7467Sayfa Aralığı: 157 - 162İngilizce

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Determination of Intrafraction Laryngeal Movement in Radiotherapy
OBJECTIVE Turk J Oncol 2020;35(2):157–62 doi: 10.5505/tjo.2020.2185 ORIGINAL ARTICLE Movement in early-stage laryngeal radiotherapy is an important factor in the success of the treatment. T hyroid cartilage may move by swallowing, breathing, sound production, and reflexes. During the treatment, the intra-fraction target movement was monitored by CBCT scans. In this study, we investigated the effects of laryngeal movement on the target volume. METHODS CT scans were performed to 16 patients with maximum neck extension and treatment plans were prepared with VMAT fields with 6MV energy. CBCT scanning was performed to all patients before the treatment and necessary corrections were made. Then, simultaneous intrafraction CBCT scanning with the VMAT field was performed during the treatment. When the treatment field was over, the deviation amounts between CT and CBTC in the lateral, vertical and longitudinal axes were determined. RESULTS T he deviation amount ≤ ±0.1cm was determined with 293 fractions in the lateral axis, 260 fractions in the vertical axis and 263 fractions in the longitudinal axis. Maximum deviation values were determined as 0.2 cm in the lateral axis, 0.5cm in the vertical axis and 0.5cm in the longitudinal axis. If the treatment has a 0.2cm CTV-PTV margin (for 305 fractions), treatment can be performed at a confidence interval of 100% on the lateral axis, 96.1% on the vertical axis and 94.1% on the longitudinal axis. CONCLUSION With the help of intra-faction monitoring, we are able to adjust the target margins and doses more precisely in laryngeal radiotherapy, especially for stereotactic treatment. To reduce possible movements in laryngeal radiotherapy, a maximum neck extension should be performed.
DergiAraştırma MakalesiErişime Açık
  • 1. Mittal B, Rao DV, Marks JE, Perez CA. Role of radiation in the management of early vocal cord carcinoma. Int J Radiat Oncol Biol Phys 1983;9(7):997–1002.
  • 2. Werner JA, Schünke M, Rudert H, Tillmann B. Description and clinical importance of the lymphatics of the vocal fold. Otolaryngol Head Neck Surg 1990;102(1):13–9.
  • 3. Pradhan S, Kannan R. Surgery for laryngeal cancer: anatomy and patterns of spread. Voice conservation surgery for laryngeal and hypopharyngeal cancer. Mumbai: Lloyds Publishing House; 2006. p. 10–5.
  • 4. Licitra L, Bernier J, Grandi C, Locati L, Merlano M, Gatta G, et al. Cancer of the larynx. Crit Rev Oncol Hematol 2003;47(1):65–80.
  • 5. Levendag PC, Teguh DN, Keskin-Cambay F, AlMamgani A, van Rooij P, Astreinidou E, et al. Single vocal cord irradiation: A competitive treatment strategy in early glottic cancer. Radiother Oncol 2011;101(3):415–9.
  • 6. Matthew CW, Yvonne DP, Rupesh K, Sara JZ, Eric M, John FG. Clinical and dosimetric implications of intensity-modulated radiotherapy for early-stage glottic carcinoma. Medical Dos 2015;41:64–9.
  • 7. AAPM. The role of in-room kV X-ray imaging for patient setup and target localization. AAPM TG-104. Madison (WI): Medical Physics Publishing; 2009. Available at: http://www.aapm.org/pubs/reports/. Accessed Feb 4, 2020.
  • 8. Seuntjens J, Lartigau EF, Cora S, Ding GX, Nuyttens J, Roberge D, et al. Prescribing, recording, and reporting of stereotactic treatments with small photon beams. ICRU report 91. J ICRU 2014;14(2):1–160.
  • 9. Gowda RV, Henk JM, Mais KL, Sykes AJ, Swindell R, Slevin NJ. Three Weeks Radiotherapy for T1 Glottic Cancer: Christie and Royal Marsden Hospital Experience. Radiother Oncol 2003;68(2):105–11.
  • 10. Ermiş E, Teo M, Dyker KE, Fosker C, Sen M, Prestwich RJ. Definitive hypofractionated radiotherapy for early glottis carcinoma: experience of 55Gy in 20 fractions. Radiat Oncol 2015;10:203.
  • 11. Elekta XVI R 5.0; Instructions for Use. Published July 2013. Available at: http://ekstern.infonet.regionsyddanmark.dk/files/Formularer/Upload/2016/02/xvi%20 R5.0_1501452%2002.pdf. Accessed Feb 4, 2020.
  • 12. Kwa SL, Al-Mamgani A, Osman SO, Gangsaas A, Levendag PC, Heijmen BJ. Inter- and intrafraction target motion in highly focused single vocal cord irradiation of t1a larynx cancer patients. Int J Radiat Oncol Biol Phys 2015;93(1):190–5.
  • 13. Kauweloa K, Wang H, Garden AS, Chi PCM, Rosenthal DI, Fuller CD, et al. Evaluation of the Larynx Motion Using Four- Dimensional and Breath-Hold Computed Tomography (Poster No: 3615). International Journal of Radiation Oncology, Biology, Physics 2017;99(Supple 2):E677.
  • 14. Baron CA, Awan MJ, Mohamed AS, Akel I, Rosenthal DI, Gunn GB, et al. Estimation of daily interfractional larynx residual setup error after isocentric alignment for head and neck radiotherapy: quality assurance implications for target volume and organs-at-risk margination using daily CT on- rails imaging. J Appl Clin Med Phys 2014;16(1):5108.
  • 15. Gangsaas A, Astreinidou E, Quint S, Levendag PC, Heijmen B. Cone-beam computed tomographyguided positioning of laryngeal cancer patients with large interfraction time trends in setup and nonrigid anatomy variations. Int J Radiat Oncol Biol Phys 2013;87(2):401–6.
  • 16. Bahig H, Nguyen-Tan PF, Filion É, Roberge D, T hanomsack P, de Guise J, et al. Larynx motion considerations in partial larynx volumetric modulated arc therapy for early glottic cancer. J Med Imaging Radiat Oncol 2017;61(5):666–73.
  • 17. Bruijnen T, Stemkens B, Terhaard C, Lagendijk JJW, Raaijmakers CP, Tijssen RH. MRI-Based Radiation T herapy: Intrafraction Motion Quantification of Head and Neck Tumors Using Cine Magnetic Resonance Imaging. International Journal of Radiation Oncology, Biology, Physics. 2018;100(5):1358.

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