TURKISH JOURNAL OF ONCOLOGY 2022 , Vol 37 , Num 4
Evaluation of the Treatment Field Deviations in Different Set-up Positions During Thoracic Radiotherapy in Lung Cancer Patients
Zeliha GÜZELÖZ1,Hülya ELLİDOKUZ2,Ayşe YILDIRIM3,Levent YİĞİTBAŞI3,Rıza ÇETİNGÖZ3
1Department of Radiation Oncology, University of Health Science, Tepecik Training and Research Hospital, İzmir-Türkiye
2Department of Preventive Medicine, Dokuz Eylül University Faculty of Medicine, İzmir-Türkiye
3Department of Radiation Oncology, Dokuz Eylül University Faculty of Medicine, İzmir-Türkiye
DOI : 10.5505/tjo.2022.3584 OBJECTIVE
The purpose of the study was to evaluate the treatment field deviations in lung cancer patients treated with thoracic radiotherapy (RT) performed using different immobilization devices into three different set-up positions and the influencing factors.

METHODS
Thirty lung cancer patients having palliative thoracic RT indication were randomized into three different set-up positions using different immobilization devices (Group I: arm along the body, Group II: lung board, and Group III: arm supported board). The treatment field center deviation was measured on sternal (X and Y axis) and axillary (z and ? axis) cross. In addition, parameters such as age, pain, pulmonary function test, set-up time, the temperature difference between the treatment room and the outside environment, and patient education level that may cause set-up were evaluated.

RESULTS
Mean intra-fraction field center deviations of 5.66±4.15 mm were observed in the right (z) axis (p=0.049) and 5.53±4.81 mm in the left (z) axis (p=0.015) in Group II which were statistically significantly larger than the deviations in other groups. A statistically significant correlation was found between the indoor and outdoor temperature difference and set-up time.

CONCLUSION
Both set-up positions of Groups I and III, gave better results than the position of Group II. According to our results, if a lung board will be used, adding the arm supporting accessory will be necessary. Random errors can be minimized and the set-up quality improved by using appropriate immobilization devices, minimizing the total set-up time and balancing the in and outdoor temperature by air conditioning system. Keywords : Immobilization device; inter-fractional motion; intra-fraction motion; lung cancer; set-up error; thoracic radiotherapy