https://he01.tci-thaijo.org/index.php/jtaro <p>วารสารฯ มีนโยบายรับตีพิมพ์บทความคุณภาพสูงในด้านรังสีรักษา มะเร็งวิทยา ฟิสิกส์การแพทย์ การพยาบาลด้านมะเร็ง รังสีเทคนิค โดยมีกลุ่มเป้าหมายคือแพทย์มะเร็งวิทยา นักฟิสิกส์การแพทย์ พยาบาล นักรังสีเทคนิค คณาจารย์ นิสิต นักศึกษา และนักวิจัยทั้งในและนอกสถาบัน</p> Thai Association of Radiation Oncology en-US Journal of Thai Association of Radiation Oncology 2730-177X <p>บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารมะเร็งวิวัฒน์ <span class="type--fade top-bar-blurb">สมาคมรังสีรักษาและมะเร็งวิทยาแห่งประเทศไทย <br><br></span>ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับ<span class="type--fade top-bar-blurb">สมาคมรังสีรักษาและมะเร็งวิทยาแห่งประเทศไทย</span> และบุคคลากรท่านอื่น ๆ ใน สมาคมฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว</p> https://he01.tci-thaijo.org/index.php/jtaro/article/view/283056 <p>Head and neck cancers present significant therapeutic challenges in radiation oncology due to the proximity of multiple radiosensitive organs and critical structures. Proton therapy has emerged as a specialized technique to minimize unintended doses to surrounding normal tissues, leveraging the physical properties of the Bragg peak to achieve maximal dose deposition at a precise depth. However, the therapeutic advantages of proton therapy are strictly dependent on highly accurate and reproducible patient immobilization. This review highlights the clinical importance of immobilization in proton therapy for head and neck malignancies and describes the essential roles of radiation therapists in device preparation and treatment simulation. By examining the technical processes of patient positioning and the utilization of various immobilization systems—including thermoplastic masks, specialized head and neck cushions (e.g., cushions), bite blocks, and related supportive accessories—this article summarizes a CT simulation workflow based on clinical experience and evidence from relevant literature. Effective immobilization is shown to reduce patient motion and breathing-induced variations, thereby minimizing range uncertainty and ensuring positional reproducibility across the entire treatment course. Furthermore, appropriate immobilization strategies decrease radiation exposure to organs at risk, directly enhancing the precision and safety of proton therapy. Consequently, the selection of appropriate devices, combined with the meticulous technical practice of skilled radiation therapists, remains a cornerstone of treatment accuracy and patient safety in this complex anatomical region.</p> Metinee Wisetrintong Nuttawut Mafoo Yupawadee Chotmit Jaruek Kanphet Copyright (c) 2026 Thai Association of Radiation Oncology http://creativecommons.org/licenses/by-nc-nd/4.0 2026-05-14 2026-05-14 32 1 Q1 Q15 https://he01.tci-thaijo.org/index.php/jtaro/article/view/283400 <p><strong>Backgrounds:</strong> Stereotactic Body Radiotherapy (SBRT) for lung cancer requires high precision because lung tumors move with respiration. Treatment planning using four-dimensional computed tomography (4D-CT) has therefore been employed. During treatment, image-guided radiation therapy (IGRT) is essential to verify tumor positioning. Both three-dimensional cone-beam CT (3D-CBCT) and four-dimensional cone-beam CT (4D-CBCT) are available, but their accuracy remains debatable. This study aims to compare matching error between these two techniques relative to average intensity projection (AIP) from 4D-CT.</p> <p><strong>Objectives:</strong> To evaluate the matching error of lung tumor positioning using 3D-CBCT and 4D-CBCT compared with 4D-CT. And to assess the feasibility of using 3D-CBCT as an alternative to 4D-CBCT.</p> <p><strong>Materials and Methods: </strong>This was a retrospective study of nine patients with lung cancer who underwent stereotactic body radiotherapy (SBRT). Tumor positioning was verified prior to each treatment fraction using image-guided radiotherapy with both three-dimensional cone-beam computed tomography (3D-CBCT) and four-dimensional cone-beam computed tomography (4D-CBCT), respectively, on a Varian TrueBeam system between 2018 and 2021. The data consisted of average intensity projection (AIP) images from 4D-CT (9 datasets) and a total of 61 sets each of 3D-CBCT and 4D-CBCT images. Matching error in the anterior–posterior(AP), superior–inferior(SI), and left–right(LR) directions were compared using an auto-matching method. Statistical analysis was performed using a paired t-test, with statistical significance defined as p &lt; 0.05.</p> <p><strong>Results: </strong>Mean matching errors relative to AIP from 4D-CT : 3D-CBCT: AP -0.31 ± 1.75 mm, SI -1.13 ± 1.57 mm, LR -0.33 ± 0.69 mm<strong> ,</strong>4D-CBCT: AP -0.28 ± 1.92 mm, SI -0.80 ± 2.00 mm, LR -0.31 ± 0.67 mm The largest mean matching errors between the two techniques was in the SI direction -0.34 mm(p=0.26), followed by AP -0.03 mm(p=0.85) and LR -0.02 mm(p=0.82). No statistically significant differences were found (p&gt; 0.05), and all values were within the 5 mm planning target volume (PTV) margin.</p> <p><strong>Conclusion: </strong>Both 3D-CBCT and 4D-CBCT demonstrated comparable accuracy when referenced to AIP from 4D-CT, with no statistically significant differences. These findings suggest that in institutions without 4D-CBCT, 3D-CBCT can be used as a clinically acceptable alternative for lung SBRT positioning verification.</p> Nattawan Muangmai Supanida Ngamdee ๋Jiraporn Settakornnukul ๊Utumporn Puangrangsa Chanida Sathitwattanavirot Pailin phalipho Copyright (c) 2026 Thai Association of Radiation Oncology http://creativecommons.org/licenses/by-nc-nd/4.0 2026-05-14 2026-05-14 32 1 R1 R17