Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Breast cancer; Cone-beam computed tomography; Set-up precision; Prone breast radiotherapy; Cancer du sein; Tomographie conique; Précision du placement; Radiothérapie en décubitus ventral

Abstract :

[en] Purpose:Feasibility evaluation of the Sagittilt© prone breast board system (Orfit Industries, Wijnegem, Belgium) for radiotherapy focusing on patient and staff satisfaction, treatment time, treatment reproducibility with the assessment of residual-intrafractional errors. Material and methods: Thirty-six patients underwent whole-breast irradiation in prone position. Seventeen received a sequential boost (breast: 42.56 Gy in 16 fractions, boost: 10 Gy in five fractions), while 19 patients received a concomitant boost protocol (breast/boost: 45.57/55.86 Gy in 21 fractions). Treatment verification included a daily online cone-beam CT (CBCT). In order to assess the residual and residual-intrafractional errors post-treatment CBCTs were performed systematically at the first five treatment sessions. Treatment time, patient comfort, staff satisfaction were also evaluated. Results: The pretreatment CBCT resulted in a population systematic error of 4.5/3.9/3.3 mm in lateral/longitudinal/vertical directions, while the random error was 5.4/3.8/2.8 mm. Without correction these would correspond to a clinical to planning target volume margin of 15.0/12.3/10.3 mm. The population systematic and random residual-intrafractional errors were 1.5/0.9/1.7 mm and 1.7/1.9/1.6 mm. Patient and staffs’ satisfaction were considered good and average. The mean treatment session time was 21 minutes (range: 13–40 min). Conclusion: The Sagittilt© system seems to be feasible for breast irradiation and well-tolerated by patients, acceptable to radiographers and reasonable in terms of treatment times. Set-up accuracy was comparable with other prone systems; residual errors need further investigations.
[fr] Objectif de l’étude: Évaluation de la faisabilité de l’irradiation du sein en décubitus ventral avec le système Sagittilt© (Orfit Industries, Wijnegem, Belgique) en étudiant la satisfaction du patient et du personnel soignant, le temps de traitement et la reproductibilité du traitement avec une évaluation de l’erreur résiduelle pendant les fractions. Méthodes: Trente-six patientes ont bénéficié d’une irradiation de la totalité du sein en décubitus ventral, 17 ont reçu un boost séquentiel (sein : 42,56 Gy en 16 fractions ; boost : 10 Gy en cinq fractions) et 19 patientes un boost concomitant (sein/boost : 45,57/55,86 Gy en 21 fractions). La vérification quotidienne du placement a été faite par une tomographie conique (CBCT). Pour évaluer l’erreur résiduelle pendant les fractions, une tomographie conique a été effectuée systématiquement après les cinq premières fractions. Le temps de traitement, le confort du patient ainsi que du personnel soignant ont également été évalués. Résultats: La tomographie conique avant le traitement a mis en évidence une erreur systématique de 4,5/3,9/3,3 mm dans les directions latérale/longitudinale/verticale, l’erreur aléatoire était de 5,4/3,8/2,8 mm. Sans correction, cela correspond à une marge du volume cible anatomoclinique (CTV) au volume cible prévisionnel (PTV) de 15,0/12,3/10,3 mm. L’erreur systématique et aléatoire pendant les fractions étaient respectivement de 1,5/0,9/1,7 mm et de 1,7/1,9/1,6 mm. La satisfaction du patient était considérée comme bonne et celle du personnel comme moyenne. Le temps moyen de traitement était de 21 minutes (13–40 min). Conclusion: Le système Sagittilt© est utilisable en routine et bien toléré par le patient, il est acceptable pour le personnel soignant avec des temps de traitement raisonnables. La précision de la mise en place est comparable avec d’autres systèmes de traitement en décubitus ventral. De plus amples investigations sont nécessaires afin d’évaluer les erreurs résiduelles.

Disciplines :

Oncology

Author, co-author :

Lakosi, Ferenc; Centre Hospitalier Universitaire de Liège - CHU > Radiothérapie

GULYBAN, Akos ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

BEN MUSTAPHA, Selma ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

NGUYEN, Viet Paul ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

BERKOVIC, Patrick ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

NOEL, Michaël ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

GOURMET, Noël ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

COUCKE, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de radiothérapie

Language :

English

Title :

Feasibility evaluation of prone breast irradiation with the Sagittilt© system including residual-intrafractional error assessment

Alternative titles :

[en] Évaluation de la faisabilité de l’irradiation du sein en décubitus ventral avec le système Sagittilt© et de l’erreur résiduelle pendant les fractions

Publication date :

15 May 2016

Journal title :

Cancer Radiotherapie

ISSN :

1278-3218

eISSN :

1769-6658

Publisher :

Elsevier, Paris, France

Volume :

3429

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 26 January 2017

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