Abstract
PurposeThe purpose of the study was to investigate if surface guided radiotherapy (SGRT) can decrease setup deviations for tangential and locoregional breast cancer patients compared to conventional laser‐based setup (LBS).Materials and MethodsBoth tangential (63 patients) and locoregional (76 patients) breast cancer patients were enrolled in this study. For LBS, the patients were positioned by aligning skin markers to the room lasers. For the surface based setup (SBS), an optical surface scanning system was used for daily setup using both single and three camera systems. To compare the two setup methods, the patient position was evaluated using verification imaging (field images or orthogonal images).ResultsFor both tangential and locoregional treatments, SBS decreased the setup deviation significantly compared to LBS (P < 0.01). For patients receiving tangential treatment, 95% of the treatment sessions were within the clinical tolerance of ≤ 4 mm in any direction (lateral, longitudinal or vertical) using SBS, compared to 84% for LBS. Corresponding values for patients receiving locoregional treatment were 70% and 54% for SBS and LBS, respectively. No significant difference was observed comparing the setup result using a single camera system or a three camera system.ConclusionsConventional laser‐based setup can with advantage be replaced by surface based setup. Daily SGRT improves patient setup without additional imaging dose to breast cancer patients regardless if a single or three camera system was used.
Highlights
Breast conserving surgery can remove macroscopic disease for early stage breast cancer.[1]
Purpose: The purpose of the study was to investigate if surface guided radiotherapy (SGRT) can decrease setup deviations for tangential and locoregional breast cancer patients compared to conventional laser‐based setup (LBS)
Reduced maximal deviations can be observed for surface based setup (SBS) compared to LBS in all three translational directions. (d) The cumulative probability of the vector offset show a significantly improved patient setup for SBS compared to LBS (P < 0.01)
Summary
Breast conserving surgery can remove macroscopic disease for early stage breast cancer.[1] After surgery some microscopic tumor foci may remain, and if not treated with radiotherapy this can lead to locoregional recurrence and/or life‐threatening distant metastases.[1] Early. Breast Cancer Trialists' Group performed a meta‐analysis of individual data for 10 801 women from 17 randomized trials and showed that the 10‐yr risk for any first recurrence was 35% for women allocated to breast conserving surgery only, and 19% for women allocated to breast conserving surgery and radiotherapy.[1] The absolute risk reduction was 16%.
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