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Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital

Background Accurate delivery of radiotherapy is a paramount component of providing safe oncological care. Margins are applied when planning radiotherapy to account for subclinical tumour spread, physiological movement and set-up error. Set-up error is unique to each radiotherapy institution and shou...

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Main Author: Vos, Andre
Other Authors: Naiker, Thuran
Format: Thesis
Language:English
Published: Division of Radiology 2021
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access_status_str Open Access
author Vos, Andre
author2 Naiker, Thuran
author_browse Naiker, Thuran
Vos, Andre
author_facet Naiker, Thuran
Vos, Andre
author_sort Vos, Andre
collection Thesis
description Background Accurate delivery of radiotherapy is a paramount component of providing safe oncological care. Margins are applied when planning radiotherapy to account for subclinical tumour spread, physiological movement and set-up error. Set-up error is unique to each radiotherapy institution and should be calculated for each organ site to ensure safe delivery of treatment. Aim and setting The aim of this study is to calculate the random and systematic set-up error for a cohort of patients with intracranial tumours treated with 3D Conformal Radiotherapy at the Department of Radiation Oncology, Groote Schuur Hospital, South Africa. After obtaining above mentioned data the ideal CTV-PTV expansion margin was calculated using published CTV-PTV expansion margin recipes. Patients and methods The Electronic Portal Images (EPID) of 20 patients who met the inclusion criteria were compared to their Digitally Reconstructed Radiograph (DRR). The set-up error for each patient was measured after which the random (s) and systematic (S) set-up error for the study group could be calculated. With both these values known the CTV-PTV expansion margin could be determined. Results The largest error was in the Superior/Inferior (SI) direction, followed by the Medial/Lateral (ML) direction and least in the Anterior/Posterior (AP) direction with 87.7%, 76.2% and 91.6% of the errors in the ML, SI and AP directions respectively being less than 3mm. There was no error larger than 5mm in the ML or AP direction with 6.1% of the SI error larger than 5mm. The random and systematic error in all three directions for this patient cohort were less than 2mm conforming to acceptable standards of delivering safe radiotherapy. Using Stroom's margin recipe (2S + 0.7s) a CTV-PTV expansion margin of 5mm can safely be applied for this patient cohort. Conclusion When treating patients with intracranial tumours at Groote Schuur Hospital the CTV-PTV expansion margin can safely be reduced from 1cm to 5mm.
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provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/33076 Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital Vos, Andre Naiker, Thuran Mac Gregor, Hannelie Radiation Oncology Background Accurate delivery of radiotherapy is a paramount component of providing safe oncological care. Margins are applied when planning radiotherapy to account for subclinical tumour spread, physiological movement and set-up error. Set-up error is unique to each radiotherapy institution and should be calculated for each organ site to ensure safe delivery of treatment. Aim and setting The aim of this study is to calculate the random and systematic set-up error for a cohort of patients with intracranial tumours treated with 3D Conformal Radiotherapy at the Department of Radiation Oncology, Groote Schuur Hospital, South Africa. After obtaining above mentioned data the ideal CTV-PTV expansion margin was calculated using published CTV-PTV expansion margin recipes. Patients and methods The Electronic Portal Images (EPID) of 20 patients who met the inclusion criteria were compared to their Digitally Reconstructed Radiograph (DRR). The set-up error for each patient was measured after which the random (s) and systematic (S) set-up error for the study group could be calculated. With both these values known the CTV-PTV expansion margin could be determined. Results The largest error was in the Superior/Inferior (SI) direction, followed by the Medial/Lateral (ML) direction and least in the Anterior/Posterior (AP) direction with 87.7%, 76.2% and 91.6% of the errors in the ML, SI and AP directions respectively being less than 3mm. There was no error larger than 5mm in the ML or AP direction with 6.1% of the SI error larger than 5mm. The random and systematic error in all three directions for this patient cohort were less than 2mm conforming to acceptable standards of delivering safe radiotherapy. Using Stroom's margin recipe (2S + 0.7s) a CTV-PTV expansion margin of 5mm can safely be applied for this patient cohort. Conclusion When treating patients with intracranial tumours at Groote Schuur Hospital the CTV-PTV expansion margin can safely be reduced from 1cm to 5mm. 2021-03-03T01:13:05Z 2021-03-03T01:13:05Z 2020 2021-03-02T19:00:01Z Master Thesis Masters MMed http://hdl.handle.net/11427/33076 eng application/pdf Division of Radiology Faculty of Health Sciences
spellingShingle Radiation Oncology
Vos, Andre
Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital
thesis_degree_str Master's
title Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital
title_full Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital
title_fullStr Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital
title_full_unstemmed Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital
title_short Determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at Groote Schuur Hospital
title_sort determination of an optimal treatment margin for intracranial tumours treated with radiotherapy at groote schuur hospital
topic Radiation Oncology
url http://hdl.handle.net/11427/33076
work_keys_str_mv AT vosandre determinationofanoptimaltreatmentmarginforintracranialtumourstreatedwithradiotherapyatgrooteschuurhospital