Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.

<h4>Background</h4>Radiotherapy plays a key role as an adjuvant treatment in pediatric Wilm's tumor, improving both survival and quality of life. The success of radiotherapy depends on the precise delivery of radiation dose to the tumor while sparing radiosensitive structures in the...

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Main Authors: Rashid Mussa Mruma, Nazima Dharsee, Christina Vallen Malichewe, Jumaa Dachi Kisukari, Furahini Yoram, Hemed Said Myanza, Stephen Shedrack Meena, Geofrey Filbert Soko
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297997&type=printable
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author Rashid Mussa Mruma
Nazima Dharsee
Christina Vallen Malichewe
Jumaa Dachi Kisukari
Furahini Yoram
Hemed Said Myanza
Stephen Shedrack Meena
Geofrey Filbert Soko
author_facet Rashid Mussa Mruma
Nazima Dharsee
Christina Vallen Malichewe
Jumaa Dachi Kisukari
Furahini Yoram
Hemed Said Myanza
Stephen Shedrack Meena
Geofrey Filbert Soko
author_sort Rashid Mussa Mruma
collection DOAJ
description <h4>Background</h4>Radiotherapy plays a key role as an adjuvant treatment in pediatric Wilm's tumor, improving both survival and quality of life. The success of radiotherapy depends on the precise delivery of radiation dose to the tumor while sparing radiosensitive structures in the vicinity of the tumor. Pediatric patients pose unique challenges in achieving accurate radiotherapy delivery due to their inability to understand instructions and the high radiosensitivity of their tissues. Thus, it is important to determine the optimum geometric verification strategy that will ensure accurate delivery of the prescribed target as specified in the patient's treatment plan.<h4>Purpose</h4>To evaluate the performance of an offline geometric correction strategy in ensuring accuracy and reproducibility during radiotherapy delivery in Wilm's tumor patients.<h4>Material and methods</h4>The extended no-action level offline correction strategy was applied in the radiotherapy delivery of 45 Wilm's tumor patients. Gross errors from the first three fractions were used to calculate the mean errors which were then applied as offline correction factors. Mean errors among different groups were compared using a two-way analysis of variance (ANOVA) and Dunnett's pairwise comparisons. All statistical analyses and data visualization were performed using GraphPad Prism version 7 (Insight Partners, GraphPad Holdings, LLC).<h4>Results</h4>A total of 45 patients were included in the study. In all three orthogonal directions, the recorded gross errors were significantly lower after the application of the systematic error corrections. Random errors were significantly larger in the longitudinal direction compared to lateral (mean difference = 0.28, p = 0.036) and vertical directions (mean difference = 0.37 cm, p = 0.003). Patients' age was a significant predictor of random errors whereby the magnitude of random error decreased with increasing age.<h4>Conclusion</h4>This study shows that the offline correction strategy used is effective in ensuring the accuracy of radiotherapy delivery in pediatric Wilm's tumor patients.
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spelling doaj.art-f6874b02a3cf459eb973cff2ef40f82e2024-02-21T05:31:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01192e029799710.1371/journal.pone.0297997Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.Rashid Mussa MrumaNazima DharseeChristina Vallen MalicheweJumaa Dachi KisukariFurahini YoramHemed Said MyanzaStephen Shedrack MeenaGeofrey Filbert Soko<h4>Background</h4>Radiotherapy plays a key role as an adjuvant treatment in pediatric Wilm's tumor, improving both survival and quality of life. The success of radiotherapy depends on the precise delivery of radiation dose to the tumor while sparing radiosensitive structures in the vicinity of the tumor. Pediatric patients pose unique challenges in achieving accurate radiotherapy delivery due to their inability to understand instructions and the high radiosensitivity of their tissues. Thus, it is important to determine the optimum geometric verification strategy that will ensure accurate delivery of the prescribed target as specified in the patient's treatment plan.<h4>Purpose</h4>To evaluate the performance of an offline geometric correction strategy in ensuring accuracy and reproducibility during radiotherapy delivery in Wilm's tumor patients.<h4>Material and methods</h4>The extended no-action level offline correction strategy was applied in the radiotherapy delivery of 45 Wilm's tumor patients. Gross errors from the first three fractions were used to calculate the mean errors which were then applied as offline correction factors. Mean errors among different groups were compared using a two-way analysis of variance (ANOVA) and Dunnett's pairwise comparisons. All statistical analyses and data visualization were performed using GraphPad Prism version 7 (Insight Partners, GraphPad Holdings, LLC).<h4>Results</h4>A total of 45 patients were included in the study. In all three orthogonal directions, the recorded gross errors were significantly lower after the application of the systematic error corrections. Random errors were significantly larger in the longitudinal direction compared to lateral (mean difference = 0.28, p = 0.036) and vertical directions (mean difference = 0.37 cm, p = 0.003). Patients' age was a significant predictor of random errors whereby the magnitude of random error decreased with increasing age.<h4>Conclusion</h4>This study shows that the offline correction strategy used is effective in ensuring the accuracy of radiotherapy delivery in pediatric Wilm's tumor patients.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297997&type=printable
spellingShingle Rashid Mussa Mruma
Nazima Dharsee
Christina Vallen Malichewe
Jumaa Dachi Kisukari
Furahini Yoram
Hemed Said Myanza
Stephen Shedrack Meena
Geofrey Filbert Soko
Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.
PLoS ONE
title Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.
title_full Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.
title_fullStr Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.
title_full_unstemmed Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.
title_short Performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for Wilm's tumor.
title_sort performance of an offline systematic error correction strategy in pediatric patients receiving adjuvant conformal radiotherapy for wilm s tumor
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297997&type=printable
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