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PTV margin calculation for head and neck patients treated with VMAT: a systematic literature review

Published online by Cambridge University Press:  19 October 2021

Kristina Caruana Open the ORCID record for Kristina Caruana [Opens in a new window] ,
Nick Refalo ,
Denise Spiteri ,
José Guilherme Couto Open the ORCID record for José Guilherme Couto [Opens in a new window] ,
Frank Zarb Open the ORCID record for Frank Zarb [Opens in a new window]  and
Paul Bezzina Open the ORCID record for Paul Bezzina [Opens in a new window]
Kristina Caruana*
Affiliation:
University of Malta, Msida Campus, Msida, Malta
Nick Refalo
Affiliation:
Sir Anthony Mamo Oncology Centre, Msida, Malta
Denise Spiteri
Affiliation:
Sir Anthony Mamo Oncology Centre, Msida, Malta
José Guilherme Couto
Affiliation:
University of Malta, Msida Campus, Msida, Malta
Frank Zarb
Affiliation:
University of Malta, Msida Campus, Msida, Malta
Paul Bezzina
Affiliation:
University of Malta, Msida Campus, Msida, Malta
*
Author for correspondence: Kristina Caruana, University of Malta, Msida Campus, Msida, Malta, MSD2080. E-mail: kristina.caruana@gov.mt
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Abstract

Aim:

The intent of the review was to identify different methodological approaches used to calculate the planning target volume (PTV) margin for head and neck patients treated with volumetric arc therapy (VMAT), and whether the necessary factors to calculate the margin size with the selected formula were used.

Materials and Methods:

A comprehensive, systematic search of related studies was done using the Hydi search engine and different databases: MEDLINE, PubMed, CINAHL, ProQuest (Nursing and Allied Health), Scopus, ScienceDirect and tipsRO. The literature search included studies published between January 2007 and December 2020. Eligibility screening was performed by two reviewers.

Results:

A total of seven studies were found. All the reviewed studies used the Van Herk formula to measure the PTV margin. None of the studies incorporated the systematic errors of target volume delineation in the PTV equation. Inter-fraction translational errors were assessed in all the studies, whilst intra-fraction errors were only included in the margin equation for two studies. The studies showed great heterogeneity in the key characteristics, aims and methods.

Findings:

Since systemic errors from target volume delineation were not considered and not all studies assess intra-fraction errors, PTV margins may be underestimated. The recommendations are that studies need to determine the effect of target volume variance on PTV margins. It is also recommended to compare PTV margin results using various formulas.

Keywords

Head and NeckVMATPlanning Target VolumePTVVan HerkMarginErrorSystematic literature review
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 4 , December 2022 , pp. 586 - 593
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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