PDF(Pubmed)
Abstract：
BACKGROUND: Surface-guided radiation therapy (SGRT) has emerged as a powerful tool to improve patient setup accuracy in radiation therapy (RT). Combined with the goal of increasing RT accuracy is an ongoing effort to decrease RT side effects. The application of a prophylactic skin dressing to the treatment site is a well-documented method of reducing skin-related side effects from RT. This paper aims to investigate whether the application of Mepitel, a prophylactic skin dressing, has an impact on the accuracy of surface-guided patient setups in chest wall RT.
METHODS: A retrospective analysis of daily image-guided Online Corrections (OLCs) from patients undergoing chest wall irradiation with SGRT was performed. Translational (superior-inferior, lateral, and anterior-posterior) OLC magnitude and direction were compared between patients treated with Mepitel applied and those treated without. Systematic and random errors were calculated and compared between groups.
RESULTS: OLCs from 275 fractions were analysed. Mean OLCs were larger for patients with Mepitel applied in the superior_inferior axis (0.34 vs. 0.22 cm, P = 0.049) and for the combined translational vector (0.54 vs. 0.43 cm, P = 0.043). Combined translational systematic error was slightly larger for patients with Mepitel applied (0.15 vs. 0.09 cm).
CONCLUSIONS: Mepitel can impact the accuracy of SGRT patient-positioning in chest wall RT. The variation however is small and unlikely to have any clinical impact if SGRT is coupled with image guidance and appropriate PTV margins. Further investigation is required to assess the effect of Mepitel on SGRT accuracy in other treatment sites, as well as any potential dosimetric impacts.
METHODS: A retrospective analysis of daily image-guided Online Corrections (OLCs) from patients undergoing chest wall irradiation with SGRT was performed. Translational (superior-inferior, lateral, and anterior-posterior) OLC magnitude and direction were compared between patients treated with Mepitel applied and those treated without. Systematic and random errors were calculated and compared between groups.
RESULTS: OLCs from 275 fractions were analysed. Mean OLCs were larger for patients with Mepitel applied in the superior_inferior axis (0.34 vs. 0.22 cm, P = 0.049) and for the combined translational vector (0.54 vs. 0.43 cm, P = 0.043). Combined translational systematic error was slightly larger for patients with Mepitel applied (0.15 vs. 0.09 cm).
CONCLUSIONS: Mepitel can impact the accuracy of SGRT patient-positioning in chest wall RT. The variation however is small and unlikely to have any clinical impact if SGRT is coupled with image guidance and appropriate PTV margins. Further investigation is required to assess the effect of Mepitel on SGRT accuracy in other treatment sites, as well as any potential dosimetric impacts.
摘要：
背景：表面引导放射治疗（SGRT）已成为提高放射治疗（RT）患者设置准确性的强大工具。与提高RT准确性的目标相结合是减少RT副作用的持续努力。将预防性皮肤敷料应用于治疗部位是减少来自RT的皮肤相关副作用的有据可查的方法。本文旨在探讨梅皮泰尔的应用,预防性皮肤敷料，对胸壁RT中表面引导患者设置的准确性有影响。
方法：对接受SGRT胸壁照射的患者进行每日图像引导的在线矫正（OLC）进行回顾性分析。翻译（上级-下级，横向,和前后）比较了接受梅皮泰尔治疗的患者与未接受治疗的患者之间的OLC大小和方向。计算并比较组间的系统性和随机误差。
结果：分析了来自275个馏分的OLC。Mepitel应用于上_下轴的患者的平均OLC较大（0.34vs.0.22cm,P=0.049）和组合翻译载体（0.54vs.0.43cm,P=0.043)。应用Mepitel的患者的综合平移系统误差稍大（0.15vs.0.09厘米）。
结论：Mepitel可以影响SGRT患者在胸壁RT中定位的准确性。然而，如果SGRT与图像指导和适当的PTV边缘相结合，则变化很小，并且不太可能产生任何临床影响。需要进一步调查，以评估梅皮泰尔对其他治疗部位SGRT准确性的影响，以及任何潜在的剂量学影响。
方法：对接受SGRT胸壁照射的患者进行每日图像引导的在线矫正（OLC）进行回顾性分析。翻译（上级-下级，横向,和前后）比较了接受梅皮泰尔治疗的患者与未接受治疗的患者之间的OLC大小和方向。计算并比较组间的系统性和随机误差。
结果：分析了来自275个馏分的OLC。Mepitel应用于上_下轴的患者的平均OLC较大（0.34vs.0.22cm,P=0.049）和组合翻译载体（0.54vs.0.43cm,P=0.043)。应用Mepitel的患者的综合平移系统误差稍大（0.15vs.0.09厘米）。
结论：Mepitel可以影响SGRT患者在胸壁RT中定位的准确性。然而，如果SGRT与图像指导和适当的PTV边缘相结合，则变化很小，并且不太可能产生任何临床影响。需要进一步调查，以评估梅皮泰尔对其他治疗部位SGRT准确性的影响，以及任何潜在的剂量学影响。
