ArticleInternational journal of radiation oncology, biology, physics2020
Estimating PTV Margins in Head and Neck Stereotactic Ablative Radiation Therapy (SABR) Through Target Site Analysis of Positioning and Intrafractional Accuracy.
Article in International journal of radiation oncology, biology, physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- A systematic review and practical considerations of stereotactic body radiotherapy in the treatment of head and neck cancer.The British journal of radiology · 2021Pooled it
- Beyond Couch Correction in Head and Neck Radiotherapy: A Narrative Review of Action-Oriented Positioning Management.Cancers · 2026Review
- Intrafractional Motion and Margin Assessment for Cone Beam Computed Tomography Guided Online Adaptive Radiation Therapy in Head and Neck Cancer.Advances in radiation oncology · 2026Article
- Article
- A prospective cohort study on stereotactic radiotherapy in the management of dural recurrence of olfactory neuroblastoma.Head & neck · 2025Article
- Stereotactic Body Radiotherapy in Recurrent and Oligometastatic Head and Neck Tumours.Journal of clinical medicine · 2024Review
- MV CBCT based assessment of setup uncertainties and planning target volume margin in head and neck cancer.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2024Article
- Target movement according to cervical lymph node level in head and neck cancer and its clinical significance.Radiation oncology journal · 2023Article
- Reirradiation of head and neck squamous cell carcinomas: a pragmatic approach, part II: radiation technique and fractionations.La Radiologia medica · 2023Review
- Review
- Brain stereotactic radiosurgery using MR-guided online adaptive planning for daily setup variation: An end-to-end test.Journal of applied clinical medical physics · 2022Article
- Highly conformal reirradiation in patients with prior oropharyngeal radiation: Clinical efficacy and toxicity outcomes.Head & neck · 2020Article
- Conventionally fractionated large volume head and neck re-irradiation using multileaf collimator-based robotic technique: A feasibility study.Clinical and translational radiation oncology · 2020Article
- Comparison of Intrafractional Motion in Head and Neck Cancer Between Two Immobilization Methods During Stereotactic Ablative Radiation Therapy by CyberKnife.Cancer management and research · 2020Article
- Dose-Escalated Magnetic Resonance Image-Guided Abdominopelvic Reirradiation With Continuous Intrafraction Visualization, Soft Tissue Tracking, and Automatic Beam Gating.Advances in radiation oncologyArticle
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Authors and funding
15 authors at 1 institution in 1 country.
Funding
Abstract
purposeRecurrent or previously irradiated head and neck cancers (HNC) are therapeutically challenging and may benefit from high-dose, highly accurate radiation techniques, such as stereotactic ablative radiation therapy (SABR). Here, we compare set-up and positioning accuracy across HNC subsites to further optimize the treatment process and planning target volume (PTV) margin recommendations for head and neck SABR. METHODS AND MATERIALS: We prospectively collected data on 405 treatment fractions across 79 patients treated with SABR for recurrent/previously irradiated HNC. First, interfractional error was determined by comparing ExacTrac x-ray to the treatment plan. Patients were then shifted and residual error was measured with repeat x-ray. Next, cone beam computed tomography (CBCT) was compared with ExacTrac for positioning agreement, and final shifts were applied. Lastly, intrafractional error was measured with x-ray before each arc. Results were stratified by treatment site into skull base, neck/parotid, and mucosal.
resultsMost patients (66.7%) were treated to 45 Gy in 5 fractions (range, 21-47.5 Gy in 3-5 fractions). The initial mean ± standard deviation interfractional errors were -0.2 ± 1.4 mm (anteroposterior), 0.2 ± 1.8 mm (craniocaudal), and -0.1 ± 1.7 mm (left-right). Interfractional 3-dimensional vector error was 2.48 ± 1.44, with skull base significantly lower than other sites (2.22 vs 2.77; P = .0016). All interfractional errors were corrected to within 1.3 mm and 1.8°. CBCT agreed with ExacTrac to within 3.6 mm and 3.4°. CBCT disagreements and intrafractional errors of >1 mm or >1° occurred at significantly lower rates in skull base sites (CBCT: 16.4% vs 50.0% neck, 52.0% mucosal, P < .0001; intrafractional: 22.0% vs 48.7% all others, P < .0001). Final PTVs were 1.5 mm (skull base), 2.0 mm (neck/parotid), and 1.8 mm (mucosal).
conclusionsHead and neck SABR PTV margins should be optimized by target site. PTV margins of 1.5 to 2 mm may be sufficient in the skull base, whereas 2 to 2.5 mm may be necessary for neck and mucosal targets. When using ExacTrac, skull base sites show significantly fewer uncertainties throughout the treatment process, but neck/mucosal targets may require the addition of CBCT to account for positioning errors and internal organ motion.
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