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1 results

  • An investigation of rotational issues for rectal carcinoma treated with radiotherapy

  • Dominique A. Taylor, Thomas ffrench, Charlotte A. Sale, Paul Foulstone
  • Journal:
    Journal of Radiotherapy in Practice / Volume 13 / Issue 2 / June 2014
    Published online by Cambridge University Press:
    23 May 2013, pp. 195-202
  • Purpose

    To quantify the amount of inter-fractional pitch for rectal carcinoma patients, to investigate the dosimetric impact of pitch on the target volume and critical structures and to determine a tolerance where no pitch correction is required.

    Materials and methods

    Daily pre-treatment images of rectal carcinoma patients were analysed to determine the residual pitch compared with the computed tomography (CT) planning scan. The dosimetric impact of pelvic rotation was modelled. The dose coverage of the clinical target volume (CTV) and small bowel were evaluated using dose–volume histograms.

    Results

    Pre-treatment images had a mean of 0·27° and standard deviation was 2·23°. The volume of CTV receiving 95% of the prescription dose altered by 0·1% when up to ±10° of pitch was simulated.

    Conclusions

    No clinically significant change in CTV coverage was found (when ±10° of pitch was simulated). A tolerance of ±10° of pitch has been implemented for rectal carcinoma patients treated with three-dimensional conformal radiotherapy in our institution, when daily pre-treatment imaging with a zero action threshold for translational shifts is used.