Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment
Total marrow (lymph node) irradiation (TMI/TMLI) delivery requires more time than standard radiotherapy treatments. The patient’s extremities, through the joints, can experience large movements. The reproducibility of TMI/TMLI patients’ extremities was evaluated to find the best positioning and redu...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/30/4/309 |
| _version_ | 1827745386574381056 |
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| author | Nicola Lambri Simone Leopoldo Antonetti Damiano Dei Luisa Bellu Stefania Bramanti Ricardo Coimbra Brioso Carmelo Carlo-Stella Isabella Castiglioni Elena Clerici Leonardo Crespi Chiara De Philippis Carmela Galdieri Daniele Loiacono Pierina Navarria Giacomo Reggiori Roberto Rusconi Stefano Tomatis Marta Scorsetti Pietro Mancosu |
| author_facet | Nicola Lambri Simone Leopoldo Antonetti Damiano Dei Luisa Bellu Stefania Bramanti Ricardo Coimbra Brioso Carmelo Carlo-Stella Isabella Castiglioni Elena Clerici Leonardo Crespi Chiara De Philippis Carmela Galdieri Daniele Loiacono Pierina Navarria Giacomo Reggiori Roberto Rusconi Stefano Tomatis Marta Scorsetti Pietro Mancosu |
| author_sort | Nicola Lambri |
| collection | DOAJ |
| description | Total marrow (lymph node) irradiation (TMI/TMLI) delivery requires more time than standard radiotherapy treatments. The patient’s extremities, through the joints, can experience large movements. The reproducibility of TMI/TMLI patients’ extremities was evaluated to find the best positioning and reduce unwanted movements. Eighty TMI/TMLI patients were selected (2013–2022). During treatment, a cone-beam computed tomography (CBCT) was performed for each isocenter to reposition the patient. CBCT-CT pairs were evaluated considering: (i) online vector shift (OVS) that matched the two series; (ii) residual vector shift (RVS) to reposition the patient’s extremities; (iii) qualitative agreement (range 1–5). Patients were subdivided into (i) arms either leaning on the frame or above the body; (ii) with or without a personal cushion for foot positioning. The Mann-Whitney test was considered (<i>p</i> < 0.05 significant). Six-hundred-twenty-nine CBCTs were analyzed. The median OVS was 4.0 mm, with only 1.6% of cases ranked < 3, and 24% of RVS > 10 mm. Arms leaning on the frame had significantly smaller RVS than above the body (median: 8.0 mm/6.0 mm, <i>p</i> < 0.05). Using a personal cushion for the feet significantly improved the RVS than without cushions (median: 8.5 mm/1.8 mm, <i>p</i> < 0.01). The role and experience of the radiotherapy team are fundamental to optimizing the TMI/TMLI patient setup. |
| first_indexed | 2024-03-11T05:06:21Z |
| format | Article |
| id | doaj.art-b12a1c17184746d1956200b9889f1b83 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T05:06:21Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-b12a1c17184746d1956200b9889f1b832023-11-17T18:52:56ZengMDPI AGCurrent Oncology1198-00521718-77292023-04-013044067407710.3390/curroncol30040309Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation TreatmentNicola Lambri0Simone Leopoldo Antonetti1Damiano Dei2Luisa Bellu3Stefania Bramanti4Ricardo Coimbra Brioso5Carmelo Carlo-Stella6Isabella Castiglioni7Elena Clerici8Leonardo Crespi9Chiara De Philippis10Carmela Galdieri11Daniele Loiacono12Pierina Navarria13Giacomo Reggiori14Roberto Rusconi15Stefano Tomatis16Marta Scorsetti17Pietro Mancosu18Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiation Oncology Department, SS. Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyDepartment of Oncology and Hematology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Milan, ItalyDepartment of Physics “G. Occhialini”, University of Milan-Bicocca, Piazza della Scienza 2, 20126 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, ItalyDepartment of Oncology and Hematology, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyDipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyRadiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, ItalyTotal marrow (lymph node) irradiation (TMI/TMLI) delivery requires more time than standard radiotherapy treatments. The patient’s extremities, through the joints, can experience large movements. The reproducibility of TMI/TMLI patients’ extremities was evaluated to find the best positioning and reduce unwanted movements. Eighty TMI/TMLI patients were selected (2013–2022). During treatment, a cone-beam computed tomography (CBCT) was performed for each isocenter to reposition the patient. CBCT-CT pairs were evaluated considering: (i) online vector shift (OVS) that matched the two series; (ii) residual vector shift (RVS) to reposition the patient’s extremities; (iii) qualitative agreement (range 1–5). Patients were subdivided into (i) arms either leaning on the frame or above the body; (ii) with or without a personal cushion for foot positioning. The Mann-Whitney test was considered (<i>p</i> < 0.05 significant). Six-hundred-twenty-nine CBCTs were analyzed. The median OVS was 4.0 mm, with only 1.6% of cases ranked < 3, and 24% of RVS > 10 mm. Arms leaning on the frame had significantly smaller RVS than above the body (median: 8.0 mm/6.0 mm, <i>p</i> < 0.05). Using a personal cushion for the feet significantly improved the RVS than without cushions (median: 8.5 mm/1.8 mm, <i>p</i> < 0.01). The role and experience of the radiotherapy team are fundamental to optimizing the TMI/TMLI patient setup.https://www.mdpi.com/1718-7729/30/4/309total marrow irradiation (TMI)total marrow lymph node irradiation (TMLI)patient positioningreproducibilityvolumetric modulated arc therapy (VMAT)radiotherapy (RT) |
| spellingShingle | Nicola Lambri Simone Leopoldo Antonetti Damiano Dei Luisa Bellu Stefania Bramanti Ricardo Coimbra Brioso Carmelo Carlo-Stella Isabella Castiglioni Elena Clerici Leonardo Crespi Chiara De Philippis Carmela Galdieri Daniele Loiacono Pierina Navarria Giacomo Reggiori Roberto Rusconi Stefano Tomatis Marta Scorsetti Pietro Mancosu Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment Current Oncology total marrow irradiation (TMI) total marrow lymph node irradiation (TMLI) patient positioning reproducibility volumetric modulated arc therapy (VMAT) radiotherapy (RT) |
| title | Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment |
| title_full | Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment |
| title_fullStr | Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment |
| title_full_unstemmed | Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment |
| title_short | Impact of the Extremities Positioning on the Set-Up Reproducibility for the Total Marrow Irradiation Treatment |
| title_sort | impact of the extremities positioning on the set up reproducibility for the total marrow irradiation treatment |
| topic | total marrow irradiation (TMI) total marrow lymph node irradiation (TMLI) patient positioning reproducibility volumetric modulated arc therapy (VMAT) radiotherapy (RT) |
| url | https://www.mdpi.com/1718-7729/30/4/309 |
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