Comparative analysis of supraclavicular area mobility in locally advanced esophageal cancer radiation therapy with two different fixed ways

doi:10.16352/j.issn.1001-6325.2022.01.023

Abstract

Abstract: Objective To compare the setup errors provided by the chest and abdomen flat frame fixation device and integral cervico-thoracic fixation device in supraclavicular regions of locally advanced esophageal cancer patients. Methods The cone beam computed tomography (CBCT) images of 50 patients with locally advanced esophageal cancer and received radiotherapy in supraclavicular region were retrospectively analyzed. The chest and abdomen flat frame fixation device (group A) or the integral cervicothoracic fixation device (group B) were used respectively with 25 in each.There were 175 CBCT images in group A and 230 CBCT images in group B. The setup errors of the two groups were analyzed, and the movement and displacement of acromioclavicular joint in three-dimensions were measured. The differences were compared by independent sample t test and rank sum test. Results The setup errors were significantly different between group A and group B. The P value in X axis (left-right) and Z axis (anterior-posterior) were both less than 0.001 (P＜0.001);The P value in pitch was less than 0.001 (P＜0.001)and roll was less than 0.05 (P＜0.05). The movement amplitude of acromioclavicular joint (ΔX, ΔY, ΔZ) of groups A and B were (0.10±0.10)cm and (0.08±0.08)cm in X axis, (0.14±0.13)cm and (0.11±0.11)cm in Y axis, (0.16±0.12)cm and (0.11±0.12)cm in Z axis. The three-dimensional displacement of groups A and B were (0.27±0.14)cm and (0.20±0.14)cm, (P＜0.001). Conclusions If the influence of rotation angle is well controlled, the application of the integral cervicothoracic fixation device is better to immobilize the acromioclavicular joint and reproduce the setup position for locally advanced esophageal cancer patients. Special attention should be paid for the influence of rotation angle on the location accuracy of target.

Key words: locally advanced esophageal cancer, acromioclavicular joint mobility, setup error analysis, radiotherapy

CLC Number:

R815.6

WAN Bao, HUAN Fu-kui, ZHAO Yu, CHEN Huan, GENG Song-song, YAN Hui, ZHANG Yan-xin. Comparative analysis of supraclavicular area mobility in locally advanced esophageal cancer radiation therapy with two different fixed ways[J]. Basic & Clinical Medicine, 2022, 42(1): 131-135.

References

[1]中国食管癌放射治疗指南(2020年版)[J]. 国际肿瘤学杂志,2020,47:641-655.
[2]Tachimori Y. Pattern of lymph node metastases of squamous cell esophageal cancer based on the anatomical lymphatic drainage system: efficacy of lymph node dissection according to tumor location[J]. Thorac Dis,2017,9:S724-S730.
[3]Tachimori Y, Ozawa S, Numasaki H, et al. Registration committee for esophageal cancer of the Japan esophageal society. supraclavicular node metastasis from thoracic esophageal carcinoma: a surgical series from a Japanese multi-institutional nationwide registry of esophageal cancer[J]. J Thorac Cardiovasc Surg, 2014,148:1224-1229.
[4]Ezzell GA,Galvin JM,Low D,et al.Guidance document on delivery,treatment planning. and clinical implementation of IMRT: report of the IMRT Subcommittee of the AAPM Radiation Therpy Committee[J]. Med Phys,2012,30:2009-2115.
[5]徐浩然,孙显松,王欣海,等.Halcyon 医用电子直线加速器对142例肺癌患者常规分割治疗模式下靶区外放边界的分析[J].基础医学与临床,2020,40:1692-1694.
[6]Stroom JC, de Boer HC, Huizenga H, et al. Inclusion of geometrical uncertainties in radiotherapy treatment plann-ing by means of coverage probability[J]. Int J Radiat Oncol Biol Phys, 1999,43:905-919.
[7]Hugo GD, Yan D, Liang J. Population and patient-specific target margins for 4D adaptive radiotherapy to account for intra- and inter-fraction variation in lung tumour position[J]. Phys Med Biol, 2007,52:257-274.
[8]Van Herk M.Errors and margins in radiotherapy[J].Semin Rasiat Oncol,2004,14:52-64.
[9]Van Herk M,Remeijer P,Rasch C,et al. The probability of correct target dosage:dose-population histograms for deriving treatment margins in radiotherapy[J].Int J Radiat Oncol Biol Phys,2000,47:1121-1135.
[10]Finnigan R, Lamprecht B, Barry T, et al. Inter- and intra-fraction motion in stereotactic body radiotherapy for spinal and paraspinal tumours using cone-beam CT and positional correction in six degrees of freedom[J]. J Med Imaging Radiat Oncol, 2016,60:112-118.
[11]王丹,沙翔燕,林海磊.中上段食管癌图像引导放疗中摆位误差及靶区外放边界的确定[J].中华放射医学与防护杂志,2014,34:610-612.
[12]徐浩然,孙显松,王欣海,等.应用锥形束CT对157例儿童腹部肿瘤摆位误差及靶区外放边界的分析[J].基础医学与临床,2019,39:1175-1177.