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Set-up variation in palliative radiotherapy: one versus three skin localisation marks

Published online by Cambridge University Press:  08 November 2019

Jelizaveta Cvetkova ,
Agnella Craig ,
Theresa O’Donovan  and
Laura Mullaney Open the ORCID record for Laura Mullaney [Opens in a new window]
Jelizaveta Cvetkova
Affiliation:
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
Agnella Craig
Affiliation:
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
Theresa O’Donovan
Affiliation:
Radiation Oncology Department, Cork University Hospital, Wilton Road, Cork, Ireland
Laura Mullaney*
Affiliation:
Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
*
Author for correspondence: Laura Mullaney, Discipline of Radiation Therapy, Trinity College Dublin, Trinity Building for Health Sciences, St James’s Hospital Campus, Dublin 8, Ireland, Tel: +353 1 896 3254. E-mail: laura.mullaney@tcd.ie
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Abstract

Background:

Accuracy and reproducibility of the patient’s position is crucial for successful delivery of radiotherapy (RT). Data on palliative patients’ set-up uncertainties are sparse. The aim of this study was to calculate set-up errors observed for palliative patients positioned using one skin mark (Group 1) versus three skin marks (Group 2) and to assess the accuracy of both approaches.

Methods:

Displacements in the left–right (L–R) and superior–inferior (S–I) directions were retrospectively analysed for 175 sites treated with a course of fractionated palliative RT. Population mean, systematic and random errors were calculated in both directions for patients positioned with one and three skin marks. Frequency of deviations was also examined for both groups.

Results:

The population mean, systematic and random errors for Group 1 and 2 for the L–R direction were 0·0, 4·4, 4·8 and 0·4, 3·1 and 3·3 mm, respectively, and in the S–I direction: 0·1, 3·4, 4·2 and 1·2, 2·7 and 3·3 mm, respectively. Frequency of images within the clinical tolerance of 5 mm was 47·1% for Group 1 and 65·9% for Group 2.

Conclusion:

Three skin marks are recommended for patients receiving a fractionated course of palliative RT, as it reduces set-up error, reduces the number of gross displacements (>10 mm) and increases the number of displacements within the clinically acceptable tolerance of 5 mm.

Keywords

localisation protocols and palliative radiotherapypalliative imagingtreatment verification
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 206 - 209
Copyright
© Cambridge University Press 2019

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