The effect of setup uncertainties on the treatment of nasopharynx cancer Journal Article


Authors: Hunt, M. A.; Kutcher, G. J.; Burman, C.; Fass, D.; Harrison, L.; Leibel, S.; Fuks, Z.
Article Title: The effect of setup uncertainties on the treatment of nasopharynx cancer
Abstract: Purpose: As radiation treatment techniques become more complicated, the need to understand the effect of uncertainties on dose distributions increases. This study investigates the effect of positional uncertainities for patients with nasopharynx carcinoma treated with a multiple field conformal boost technique. Three dimensional setup errors were measured for six patients and the effect on patient dose was evaluated using dose volume histograms. Methods and Materials: A method is presented for determining 3-dimensional translational and rotational setup errors by identifying anatomical landmarks on two treatment field images and their corresponding simulation images. Measurements were made on a daily basis for six patients undergoing conformal treatment. Results: The average magnitude of the tmnsiational errors was between 1.5 and 3 mm while the average distance between simulation and treatment isocenters was 5 mm. Both systematic and random setup errors were observed. Dose volume histograms incorporating these uncertainties for standard parallel opposed and conformal techniques were generated for patients experiencing random and systematic setup errors. Conclusion: The data imply that positional uncertainties effect the daily dose distributions for target and critical structures differently and that the effect may be treatment technique dependent. These results demonstrate the need to measure setup uncertainties for all sites and to develop techniques for incorporating dose uncertainties in treatment plans. © 1993.
Keywords: cancer recurrence; treatment planning; reproducibility; accuracy; radiotherapy dosage; calibration; image enhancement; dosimetry; patient positioning; nasopharynx cancer; posture; nasopharyngeal neoplasms; error; mathematical analysis; computer system; human; priority journal; article; x ray dose distribution; conformal treatment planning; treatment reproducibility
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 27
Issue: 2
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 1993-09-30
Start Page: 437
End Page: 447
Language: English
DOI: 10.1016/0360-3016(93)90257-v
PUBMED: 8407420
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Chandra M Burman
    154 Burman
  2. Zvi Fuks
    425 Fuks
  3. Steven A Leibel
    252 Leibel
  4. Gerald J Kutcher
    106 Kutcher
  5. Margie A Hunt
    286 Hunt
  6. Louis B Harrison
    123 Harrison