Use head thermoplastic mask and breast bracket with body markers for breast cancer patient improves setup accuracy of intensity-modulated radiotherapy

Abstract

Abstract:ObjectiveTo study the effect of using head thermoplastic mask and breast bracket combined with body marker to decrease setup errors in intensity-modulated radiotherapy (IMRT) of chest wall and clavicular region.MethodsTen breast cancer patients receiving IMRT on chest wall and sup/infraclavicular regional lymph nodes after breast surgery were enrolled. Each patient with breast bracket was immobilized into 3 positions: using breast bracket only (group A), using body marker with breast bracket (group B) and using body marker and head thermoplastic mask with breast bracket (group C). Setup errors of irradiation field center, spinous process of clavicular region and clavicle were examined using X-ray simulator once a week for 5 week with each position and compared. All ten patients were treated IMRT with position in group C.ResultsA total of 141 set of data in all 3 groups (47 set of data each group) were gotten. The setup errors of irradiation field center in 3 directions of left-right, superior-inferior and anterior-posterior in group C were significantly less than those in group A and B (P<0.05). Setup errors of spinous process of clavicular region in left-right direction increased with the distance from inferior margin to above of clavicular head. There were 12.8%, 6.4% and 2.1% of setup errors more than 5 mm in left-right direction at 6 cm above clavicular head in group A, B and C, respectively. Setup errors of patients in group C were significantly less than those in group A and B (P<0.05) except for those of superior margin of clavicular head and 1 cm, 2 cm above clavicular head. Setup errors of clavicle in superior-inferior direction in group C were significantly less than those in group A and B (P<0.001).ConclusionsHead thermoplastic mask and breast bracket combined with body markers could reduce setup errors of irradiation field center, spinous process of clavicular region and clavicle, which improved setup accuracy of IMRT for breast cancer patients.

Key words:Intensity-modulated radiotherapy,Breast cancer,Breast bracket,Thermoplastic mask,Setup error

CLC Number:

R737.9

JIANG Qing, ZHU Ming, XU Cheng, WANG Shubei, CAO Lu, CAI Rong, CHEN Jiayi, CAI Gang. Use head thermoplastic mask and breast bracket with body markers for breast cancer patient improves setup accuracy of intensity-modulated radiotherapy[J]. Journal of Surgery Concepts & Practice, 2019, 24(05): 446-451.

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