Abstract
Purpose: Use daily patient imaging to calculate cumulative dose to target and organs at risk during the course of radiation treatment for cervical cancer patients and compare with the planned dose.Methods: Daily cone beam CT (CBCT) scans were taken for 10 patients during their cervical cancer radiation therapy treatment course. Dose from the treatment plan was calculated on each of the CBCTs. Deformable registration was performed on each of the daily CBCTs in order to map the patientˈs daily anatomy and dose onto the planning CT (reference). The cumulative dose was then calculated and the Dose Volume Histogram (DVH) of the cumulative dose was compared to the DVH of the original planned dose. Results: The DVH for the calculated cumulative dose deviated from the DVH of the actual dose due to changes in the patientsˈ daily anatomy. The planning target volume (PTV) showed similar coverage; however, the dose received by the organs at risk (OARs) differed from the original plan. Conclusions: Since patient anatomy varies on a daily basis, daily imaging combined with deformable registration and cumulative dose calculations yields an accurate dose to target and organs at risk. This dose information can then be used by the clinician to guide additional radiation therapy to boost target dose and spare OARs. This work was supported by Varian Medical Systems, Inc.
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