Comparison of set up error of SBRT technique between Vision RT and Gating (RPM) for lung cancer using Cone-beam computed tomography (CBCT) at Chulalongkorn hospital.
Keywords:
SBRT, DIBH, Vision RT, Respiratory GatingAbstract
Background: Radiation therapy for lung cancer using Stereotactic Body Radiation Therapy (SBRT) involves delivering high doses of radiation to the cancerous tumor. However, since the lungs are constantly moving due to breathing, the tumor can also move. Therefore, it is necessary to have patient positioning devices to minimize the movement of the tumor and ensure the highest accuracy in patient positioning during radiation treatment.
Objectives: This study aims to compare the effectiveness of DIBH SBRT in lung cancer patients with the Vision RT system and Real-time position management system (RPM, Gating).
Materials and methods: This study is a retrospective study of a total of 30 patients who received treatment from January 2021 to December 2022, divided into 2 groups both receiving a DIBH SBRT at lung lesion treatment. The first one was combined with the Vision RT system, and the second one was with respiratory gating. Compared both groups by using shift value from image-guided radiation therapy (IGRT) which was a Cone-beam computed tomography (CBCT) and analyzed by using percentage, mean, standard deviation, and t-test.
Results: For DIBH SBRT in lung lesions combined with Vision RT, the mean shift values from CBCT in vertical, longitudinal, and lateral were 0.25+0.19 cm, 0.35+0.25 and 0.19+0.19 cm, respectively. For DIBH SBRT combined with respiratory gating, the mean shift values from CBCT in vertical, longitudinal, and lateral were 0.41+0.26 cm, 0.5+0.44 cm. and 0.27+0.23 cm, respectively. A statistically significant difference was observed between the two systems in the vertical direction (p-value = 0.0001), the longitudinal direction (p-value = 0.02), and the lateral direction (p-value = 0.04).
Conclusion: Treating lung cancer patients by using DIBH SBRT techniques combined with Vision RT can lower the shift values in CBCT caused by positioning error compared to the use of respiratory gating. Which can lower the change in re-positioning leading to the unnecessary exposure dose.
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