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  • Research Article   
  • J Oncol Res Treat 4: 131,

Set-up Errors and Imaging Verification Protocols for Head and Neck Cancers Radiotherapy in Morocco

El Amin Marnouche1*, Maghous Abdelhak1, Issam Lalya2, Noha Zaghba1, Amine Bazine3, Khalid Andaloussi1, Mohamed Elmarjany1, Khalid Hadadi1, Hassan Sifat1 and Hamid Mansouri1
1Department of Radiotherapy, Mohamed V Military Hospital, Rabat, Morocco
2Department of Radiation Therapy Marrakech, Morocco
3Department of Radiation Therapy Meknes, Morocco
*Corresponding Author : El Amin Marnouche, Radiation Oncologist, Department of radiotherapy Mohamed V Military Hospital, Rabat, Morocco, Tel: +212 5377-14419, Email: elaminmarnouche@gmail.com

Received Date: Jan 21, 2019 / Accepted Date: Jan 28, 2019 / Published Date: Feb 04, 2019

Abstract

Purpose: The goal of this study, the first of its kind in Morocco, was to evaluate 3D set-up errors and to propose optimal margins for (Planning Target Volume) coverage in head and neck cancers. We investigated if others imaging frequency protocols were as effective as the daily one.
Methods: The alignment data from 20 patients, with daily orthogonal kilovoltage images, were collected and analyzed. The population systematic and random errors and the 3D vector of displacements were calculated. The (Clinical Target Volume) to PTV margin was generated with mathematic formulas (van Herk, Stroom, and ICRU). Other imaging protocols were simulated to evaluate the effect of imaging frequencies on the set-up errors: daily, No Action Level 5, extended No Action Level, weekly.
Results: Ninety eight percent of the set-up deviations were within 5 mm in all three directions. The population systematic and random error ranged from 0 to 0.35 mm and from 4.6 to 5.6 mm respectively. The CTV-PTV margin was, using van Hersk formulae, 4.23, 4.23, 3.96 mm in AP (Top), ML (Center) and SI (Bottom) directions respectively. There was no difference between the daily protocol and eNAL protocol (p=0.08) with 98% and 96.4% of 3D vectors within 3D vector PTV respectively. The eNAL protocol provided the best coverage of residual set up errors by the calculated CTV to PTV margin especially in the AP direction (95.8% with p<0.001).
Conclusion: A 5 mm extension of CTV to PTV margin seems to be the optimal margin. The eNAL could be strongly considered as a verification imaging protocol; however more studies are needed to confirm this result. 

Keywords: Set up errors; PTV margin; Verification imaging protocol 

Citation: Marnouche EA, Abdelhak M, Lalya I, Zaghba N, Bazine A, et al. (2019) Set-up Errors and Imaging Verification Protocols for Head and Neck Cancers Radiotherapy in Morocco. J Oncol Res Treat 4: 131.

Copyright: © 2019 Marnouche EA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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