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PTV margin calculation for head and neck patients treated with VMAT: a systematic literature review

Published online by Cambridge University Press:  19 October 2021

Kristina Caruana Open the ORCID record for Kristina Caruana [Opens in a new window] ,
Nick Refalo ,
Denise Spiteri ,
José Guilherme Couto Open the ORCID record for José Guilherme Couto [Opens in a new window] ,
Frank Zarb Open the ORCID record for Frank Zarb [Opens in a new window]  and
Paul Bezzina Open the ORCID record for Paul Bezzina [Opens in a new window]
Kristina Caruana*
Affiliation:
University of Malta, Msida Campus, Msida, Malta
Nick Refalo
Affiliation:
Sir Anthony Mamo Oncology Centre, Msida, Malta
Denise Spiteri
Affiliation:
Sir Anthony Mamo Oncology Centre, Msida, Malta
José Guilherme Couto
Affiliation:
University of Malta, Msida Campus, Msida, Malta
Frank Zarb
Affiliation:
University of Malta, Msida Campus, Msida, Malta
Paul Bezzina
Affiliation:
University of Malta, Msida Campus, Msida, Malta
*
Author for correspondence: Kristina Caruana, University of Malta, Msida Campus, Msida, Malta, MSD2080. E-mail: kristina.caruana@gov.mt
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Abstract

Aim:

The intent of the review was to identify different methodological approaches used to calculate the planning target volume (PTV) margin for head and neck patients treated with volumetric arc therapy (VMAT), and whether the necessary factors to calculate the margin size with the selected formula were used.

Materials and Methods:

A comprehensive, systematic search of related studies was done using the Hydi search engine and different databases: MEDLINE, PubMed, CINAHL, ProQuest (Nursing and Allied Health), Scopus, ScienceDirect and tipsRO. The literature search included studies published between January 2007 and December 2020. Eligibility screening was performed by two reviewers.

Results:

A total of seven studies were found. All the reviewed studies used the Van Herk formula to measure the PTV margin. None of the studies incorporated the systematic errors of target volume delineation in the PTV equation. Inter-fraction translational errors were assessed in all the studies, whilst intra-fraction errors were only included in the margin equation for two studies. The studies showed great heterogeneity in the key characteristics, aims and methods.

Findings:

Since systemic errors from target volume delineation were not considered and not all studies assess intra-fraction errors, PTV margins may be underestimated. The recommendations are that studies need to determine the effect of target volume variance on PTV margins. It is also recommended to compare PTV margin results using various formulas.

Keywords

Head and NeckVMATPlanning Target VolumePTVVan HerkMarginErrorSystematic literature review
Type
Literature Review
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 4 , December 2022 , pp. 586 - 593
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Jones, D. ICRU Report 50—Prescribing, Recording and Reporting Photon Beam Therapy. [Online] American Association of Physicists in Medicine; 1994, 833–834. Available from: doi: 10.1118/1.597396 Google Scholar
Gregoire, V, Mackie, T R. Dose prescription, reporting and recording in intensity-modulated radiation therapy: a digest of the ICRU Report 83. London: Future Medicine Ltd; 2011;3(3): 367–373. Available from: doi: 10.2217/iim.11.22 CrossRefGoogle Scholar
Gill, S K, Reddy, K, Campbell, N, Chen, C, Pearson, D. Determination of optimal PTV margin for patients receiving CBCT-guided prostate IMRT: comparative analysis based on CBCT dose calculation with four different margins. United States: Wiley; 2015;16(6): 252–262. Available from: doi: 10.1120/jacmp.v16i6.5691 CrossRefGoogle Scholar
Eldawlatly, A, Alshehri, H, Alqahtani, A, Ahmad, A, Al-Dammas, F, Marzouk, A. Appearance of Population, Intervention, Comparison, and Outcome as research question in the title of articles of three different anesthesia journals: A pilot study. Saudi J Anaesth 2018; 12: 283–286.CrossRefGoogle ScholarPubMed
Snilstveit, B, Oliver, S, Vojtkova, M. Narrative approaches to systematic review and synthesis of evidence for international development policy and practice. Informa UK Limited; 2012;4(3): 409–429. Available from: doi: 10.1080/19439342.2012.710641 CrossRefGoogle Scholar
Bruijnen, T, Stemkens, B, Terhaard, C H, Lagendijk, J J, Raaijmakers, C P, Tijssen, R H. Intrafraction motion quantification and planning target volume margin determination of head-and-neck tumors using cine magnetic resonance imaging. Ireland: Elsevier BV; 2019;130:82–88. Available from: doi: 10.1016/j.radonc.2018.09.015 CrossRefGoogle Scholar
Yin, W-J, Sun, Y, Chi, F, et al. Evaluation of inter-fraction and intra-fraction errors during volumetric modulated arc therapy in nasopharyngeal carcinoma patients. England: BioMed Central Ltd; 2013;8(1): 78. Available from: doi: 10.1186/1748-717X-8-78 CrossRefGoogle Scholar
Anjanappa, M, Rafi, M, Bhasi, S, et al. Setup uncertainties and PTV margins at different anatomical levels in intensity modulated radiotherapy for nasopharyngeal cancer. Netherlands: Elsevier Urban & Partner Sp. z o.o; 2017;22(5): 396–401. Available from: doi: 10.1016/j.rpor.2017.07.005 CrossRefGoogle Scholar
Stroom, J, Gilhuijs, K, Vieira, S, et al. Combined recipe for clinical target volume and planning target volume margins. Int J Radiat Oncol Biol Phys 2014; 88 (3): 708–714. doi: 10.1016/j.ijrobp.2013.08.028 CrossRefGoogle ScholarPubMed
Martins, L, Couto, J G, Barbosa, B. Use of planar kV vs. CBCT in evaluation of setup errors in oesophagus carcinoma radiotherapy. Rep Pract Oncol Radiother 2016; 21 (1), 57–62. doi: 10.1016/j.rpor.2015.10.005 CrossRefGoogle ScholarPubMed
Oh, Y, Baek, J, Kim, O Kim, J. Assessment of setup uncertainties for various tumor sites when using daily CBCT for more than 2200 VMAT treatments. J Appl Clin Med Phy 2014; 15 (2): 85–99. doi: 10.1120/jacmp.v15i2.4418 CrossRefGoogle ScholarPubMed
Kukolowicz, P, Mietelska, M, Kiprian, D. Effectiveness of the No action level protocol for head & neck patients – Time considerations. Elsevier B.V; 2020; Available from: doi: 10.1016/j.rpor.2020.04.005 CrossRefGoogle Scholar
Deb, J, Chaudhuri, S, Panda, D, et al. Retrospective analysis of random and systematic errors in radiation therapy of head and neck cancer patients and its clinical predictive implications with VMAT treatment. 2019;7(7): 2758. Available from: doi: 10.18203/2320-6012.ijrms20192914 CrossRefGoogle Scholar
Norfadilah, M N, Ahmad, R, Heng, S P, Lam, K S, Radzi, A B A, John, L S H. Immobilisation precision in VMAT for oral cancer patients. 2017;851:12025. Available from: doi: 10.1088/1742-6596/851/1/012025 CrossRefGoogle Scholar
Namysł-Kaletka, A, Tukiendorf, A, Wydmański, J. Calculation of planning target volume margins using the van Herk, Stroom and ICRU methods in patients with gastric cancer. Oncol Radiother 2015; 3 (33).Google Scholar
van Herk, M, Remeijer, P, Rasch, C, Lebesque, J V. The probability of correct target dosage: dose-population histograms for deriving treatment margins in radiotherapy. Int J Radiat Oncol Biol Phys 2000; 47 (4): 1121–1135. doi: 10.1016/s0360-3016(00)00518-6 CrossRefGoogle ScholarPubMed
Cheo, T, Loh, Y, Chen, D, Lee, KM, Tham, I. Measuring radiotherapy setup errors at multiple neck levels in nasopharyngeal cancer (NPC): A case for differential PTV expansion. Ireland: Elsevier Ireland Ltd; 2015;117(3): 419–424. Available from: doi: 10.1016/j.radonc.2015.09.032 CrossRefGoogle Scholar
Van Herk, M. Errors and Margins in Radiotherapy. United States: Elsevier inc;2004;14(1): 52–64. Available from doi: 10.1053/j.semradonc.2003.10.003 CrossRefGoogle Scholar
Shikha, G, Kataria, T. Image guidance in radiation therapy: techniques and applications. Radiol Res Pract 2014; 2014:705604–10. doi: 10.1155/2014/705604 Google Scholar
Gurney-Champion, O J, McQuaid, D, Dunlop, A, et al. MRI-based assessment of 3D intrafractional motion of head and neck cancer for Radiation Therapy. Int J Radiat Oncol Biol Phys 2018; 100 (2): 306–316. doi: 10.1016/j.ijrobp.2017.10.016 CrossRefGoogle ScholarPubMed
Hoogeman, M S, Nuyttens, J J, Levendag, P C, Heijmen, BJM Time dependence of intrafraction patient motion assessed by repeat stereoscopic imaging. Int J Radiat Oncol Biol Phys 2008; 70 (2): 609–618. doi: 10.1016/j.ijrobp.2007.08.066 CrossRefGoogle ScholarPubMed
Chang, J. A statistical model for analyzing the rotational error of single isocenter for multiple targets technique. Medical Physics (Lancaster) 2017; 44 (6): 2115–2123. doi: 10.1002/mp.12262 Google ScholarPubMed
Zhang, Q, Song, Y,Chan, M, Burman, C, Yamada, Y. Feasibility study of real-time planning for stereotactic radiosurgery. United States: American Association of Physicists in Medicine; 2013;40(3):031711-n/a. Available from: doi: 10. 1118/1.4792637 Google Scholar
Vinod, S K, Jameson, M G, Min, M. Holloway, L C. Uncertainties in volume delineation in radiation oncology: a systematic review and recommendations for future studies. Radiother Oncol 2016; 121 (2): 169–179. doi: 10.1016/j.radonc.2016.09.009 CrossRefGoogle ScholarPubMed
Segedin, B, Petric, P. Uncertainties in target volume delineation in radiotherapy – are they relevant and what can we do about them? Radiol Oncol 2016a; 50 (3): 254–262. doi: 10.1515/raon-2016-0023 CrossRefGoogle Scholar
Kirkham, J J, Dwan, K M, Altman, D G, Gamble, C, Dodd, S, Smyth, R, Williamson, P R The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews. Bmj 2010; 340 (7747): 637–640. doi: 10.1136/bmj.c365 CrossRefGoogle ScholarPubMed
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