Abstract

To measure the setup error of the patient's positioning using cone-beam computed tomography during radiation therapy treatment fractions by finding systematic, random errors and the planned target volume errors. The observational, longitudinal cohort study was conducted at the Al-Warith International Cancer Institute, Karbala, Iraq, from January to May 2022, and comprised patients with head and neck cancer who underwent radiation therapy. The oncologist delineated and the medical physicist planned. Then the medical physicist modified the positioning system using the cone beam computed tomography option workstation. The vertical value was taken in anteroposterior site, longitudinal in superoinferior, and lateral in e mediolateral. The SPSS 25 were used to analyse data. Of the 31 patients, 17(54.8%) were females and 14(45.2%) were males. The overall mean age was 48.3 ± 10.22 (range: 4-77 years), and 22(70.96%) patients had been treated previously with chemotherapy. The lateral shifting inaccuracy 2.501mm was above the limit, whereas the vertical shifting 1.164mm was within acceptable limits (±2mm). The longitudinal shifting had the smallest displacement 0.436mm. Random error displayed longitudinal moving 1.965mm, lateral shifting 0.623mm and vertical shifting 0.276mm. The planned target volume margins were too wide in longitudinal shifting 3.333mm. Vertical shifting 0.481mm was greater than lateral 1.092mm, but both were within limits (±2mm). Radiation-induced errors in normal tissues must be reduced by reducing planned target volume margins, especially for longitudinal and lateral directions.

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