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Journal of Peking University(Health Sciences) >

2022 , Vol. 54 >Issue 1: 182 - 186

DOI: https://doi.org/10.19723/j.issn.1671-167X.2022.01.029

Dosimetric effect of patient arm position on Cyberknife radiosurgery for spinal tumors

  • Jun LI ,
  • Xu-hong LIU ,
  • Gong WANG ,
  • Cheng CHENG ,
  • Hong-qing ZHUANG ,
  • Rui-jie YANG
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  • 1. Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
    2. Yunnan Cancer Hospital, Kunming 650018, China
    3. The Third Affiliated Hospital of Kunming Medical University, Kunming 650018, China

Received date: 2021-02-23

  Online published: 2022-02-21

Supported by

National Natural Science Foundation of China(81372420);Beijing Municipal Commission of Science and Technology Collaborative Innovation Project(Z201100005620012);Natural Science Foundation of Beijing(7202223)

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Abstract

Objective: To assess the potential dosimetric effects of arms movement in patients with Cyberknife spine tumors. Methods: In the study, 12 patients with thoracic and lumbar tumors were retrospectively selected respectively. The contour of the patient’s arms was sketched and the CT density was modified to be equivalent to air in order to simulate the extreme case when the arm was completely removed from the radiation fields. The dose of simulated plan was re-calculated with the original beam parameters and compared with the original plan. The changes of V100, D95, and D90, conformity index (CI) and heterogeneity index (HI) in planning target volume (PTV), as well as Dmax, D1cc and D2cc in the spinal cord, stomach, esophagus, and intestines were analyzed by comparing with the original plans. Results: Compared with the original treatment plan, V100, D95, D90 and CI of PTV for the simulated plan was increased by 0.86%, 2.02%,1.97% and 0.80% respectively, the difference was statistically significant (P<0.05). Dmax, D1cc and D2cc of spinal cord was increased by 2.35%, 0.59% and 1.49% on average, compared with the original plan, the difference was statistically significant (P<0.05). The difference was statistically significant only in average D2cc of stomach, which was increased by 1.70%, compared with the original plan (P<0.05). There was no significant difference in dose change of eso-phagus and intestine between the original and simulated plans. Conclusion: This study analyzed the most extreme arm position in spinal tumor of radiation therapy based on Cyberknife. It was found that the change of arm position had little effect on dosimetry. In addition, with the change of arm position, the dose in PTV and organ at risk (OAR) increased, but the increase was relatively small. Therefore, in some special cases where the patient really can’t keep the arm position consistent during treatment, reasonable adjustment can be accepted. However, in order to ensure accurate radiotherapy, patient position should be as stable and consistent as possible.

Key words： Cyberknife; Position of arm; Spinal tumor; Dosimetry

Cite this article

Jun LI , Xu-hong LIU , Gong WANG , Cheng CHENG , Hong-qing ZHUANG , Rui-jie YANG . Dosimetric effect of patient arm position on Cyberknife radiosurgery for spinal tumors[J]. Journal of Peking University(Health Sciences), 2022 , 54(1) : 182 -186 . DOI: 10.19723/j.issn.1671-167X.2022.01.029

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