Optimization of brain tumours irradiation determining the set-up margin

Abstract

The aim of this work was to evaluate whether the excising margin of the clinical tumor volume and planning target volume correspond with calculated radiation margin based on systematic errors, and definition of radiation margins of individual brain lobes. This research was a retrospective cross-sectional study. We checked the systematic errors and calculated their average and the size of radiation margins. The average systematic errors were calculated in four directions: lateral, longitudinal, vertical, and rotation. The largest average systematic error was calculated in the lateral direction in the cerebellar area, and the error was also statistically significant(p < 0.05). In rotational direction we notice the statistically significant difference in frontal lopbe (p = 0.037), and cerebellar area (p = 0.002). The largest safety margin, as measured by the apverage systematic errors, is requirped for irradiation of the cerebellum. The safety margin size of 6.94 mm was calculated according to the formula of Van Herk. However, the smallest safety margin can be used for irradiation of the occipital lobe of the brain, namely 4.85 mm. The linear regression results that only cerebellar lesions affect lateral displacements. Based on our calculation of the mean systematic errors, we estimate that the clinical target volume - planning target volume safety margin can't be reduced further from the current 5 mm to a size of 3 mm without the use of image guided radiotherapy.

Keywords

• brain tumor
• geometric verification of radiation
• modern radiation therapy technique
• radiation treatment margin
• radiotherapy