Comparison of the fixation accuracy of polyurethane foam gel combined with individualized headrest in postoper-ative radiotherapy for breast cancer patients
YANG Jin
FANG Jian-nan
CHEN Guo-quan
WANG Xi-xian
QIU Xia-hong
GUO Zai-ren
SONG Chao-rui
SHI Jun-tian
MA Yu-jia
HUANG Xiao-bo
Abstract：Objective To investigate the fixation accuracy of polyurethane foam gel combined with individualized headrest in postoperative radiotherapy for breast cancer and to improve the accuracy and reproducibility of breast cancer ra-diotherapy positioning.Methods Fifty-two patients undergoing postoperative radiotherapy for breast cancer were divid-ed into two groups:the control group(using polyurethane foam gel)and the study group(using polyurethane foam gel combined with individualized headrest).Tangential radiotherapy was delivered to the breast/chest wall and supraclavicular region using intensity-modulated radiation therapy(IMRT).Cone-beam computed tomography(CBCT)images were used for image guidance registration to obtain setup errors in the breast/chest wall and supraclavicular target areas.The consistency of the positions of the breast/chest wall and supraclavicular target areas in 327 sets of CBCT images was ana-lyzed between the two groups.Results There was no statistically significant difference in the translation errors of the breast/chest wall target area in the anterior-posterior and cranio-caudal directions between the two groups(P＞0.05).In the left-right direction,the study group was superior to the control group[(1.87±1.45)mm vs.(2.32±1.66)mm,P=0.012].The rotation error in the anterior-posterior direction was lower in the study group than in the control group[(0.78±0.66)° vs.(0.97±0.79)°,P=0.029].For the supraclavicular region,there was no statistically sig-nificant difference in the translation errors in the cranio-caudal and cranio-caudal directions between the two groups(P＞0.05).In the left-right direction,the study group was superior to the control group[(2.07±1.65)mm vs.(2.53±1.96)mm,P=0.047].The rotation errors in the left-right and cranio-caudal directions were lower in the study group than in the control group[(0.79±0.67)° vs.(1.07±0.88)°,P=0.009;and(0.52±0.41)° vs.(0.79±0.67)°,P=0.001],with no statistically significant difference in the cranio-caudal direction.The PTV mar-gins for the breast/chest wall target area in the study group and control group were 2.62 mm and 3.74 mm(left-right),3.46 mm and 3.64 mm(cranio-caudal),and 3.30 mm and 3.26 mm(anterior-posterior),and for the supraclavicular region were 3.36 mm and 4.38 mm(left-right),and 3.49 mm and 2.98 mm(cranio-caudal),and 4.14 mm and 4.35 mm(anterior-posterior).Conclusion Polyurethane foam gel combined with individualized headrest fixation can improve the fixation accuracy of postoperative radiotherapy for breast cancer in breast/chest wall and supraclavicular target areas,with higher consistency in the positioning of the breast/chest wall and supraclavicular regions.
Keywords：head fixationsetup errorsbreast cancerradiation therapy
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 479-484 )