A comparison of two immobilization systems for stereotactic body radiation therapy of lung tumors

Han, Kathy; Cheung, Patrick; Basran, Parminder S.; Poon, Ian; Yeung, Latifa; Lochray, Fiona

doi:10.1016/j.radonc.2010.01.025

« Previous Next »Radiotherapy & Oncology
Volume 95, Issue 1 , Pages 103-108, April 2010

A comparison of two immobilization systems for stereotactic body radiation therapy of lung tumors

Kathy Han
- Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
Patrick Cheung
- Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
- Corresponding author. Address: Department of Radiation Oncology, Odette Cancer Center, T2-105, Sunnybrook Health Sciences Center, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5.
Parminder S. Basran
- Department of Medical Physics, BC Cancer Agency—Vancouver Island Center, Victoria, British Columbia, Canada
Ian Poon
- Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
Latifa Yeung
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
Fiona Lochray
- Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada

Received 7 September 2009; received in revised form 8 January 2010; accepted 31 January 2010. published online 02 March 2010.

Abstract

Purpose

This study aims to compare the efficacy, efficiency and comfort level of two immobilization systems commonly used in lung stereotactic body radiation therapy (SBRT): the Bodyfix and the abdominal compression plate (ACP).

Materials and methods

Twenty-four patients undergoing SBRT for medically inoperable stage I lung cancer or pulmonary metastases were entered on this prospective randomized study. All underwent 4DCT simulation with free breathing, the Bodyfix, and the ACP to assess respiratory tumor motion. After CT simulation, patients were randomly assigned to immobilization with either the Bodyfix or the ACP for the actual SBRT treatment. Cone beam CTs (CBCTs) were acquired before and after each treatment to assess intrafraction tumor motion. Setup time and patient comfort were recorded.

Results

There were 16 upper lobe, two middle lobe and seven lower-lobe lesions. Both the Bodyfix and the ACP significantly reduced the superior–inferior (SI) and overall respiratory tumor motion compared to free breathing (4.6 and 4.0 vs 5.3mm; 5.3 and 4.7 vs 6.1mm, respectively, p<0.05). The ACP further reduced the SI and overall respiratory tumor motion compared to the Bodyfix (p<0.05). The mean overall intrafraction tumor motion was 2.3mm with the Bodyfix and 2.0mm with the ACP (p>0.05). The ACP was faster to set up and rated more comfortable by patients than the Bodyfix (p<0.05).

Conclusions

While there is no significant difference between the Bodyfix and ACP in reducing intrafraction tumor motion, the ACP is more comfortable, faster to set up, and superior to the Bodyfix in reducing SI and overall respiratory tumor motion.

Keywords: Stereotactic body radiation therapy, Respiratory tumor motion, Intrafraction tumor motion, Non-small cell lung cancer, Bodyfix, Abdominal compression plate