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Surface-guided radiation therapy for breast cancer: more precise positioning

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Abstract

Introduction

Hypofractionated radiation therapy for breast cancer requires highly precise delivery through the use of image-guided radiotherapy (IGRT). Surface-guided radiation therapy (SGRT) is being increasingly used for patient positioning in breast radiotherapy. We aimed to assess the role of SGRT for verification of breast radiotherapy and the tumour bed.

Materials and methods

Prospective study of 252 patients with early stage breast cancer. A total of 1170 determinations of daily positioning were performed. Breast surface positioning was determined with SGRT (AlignRT) and correlated with the surgical clips in the tumour bed, verified by IGRT (ExacTrac).

Results

SGRT improved surface matching by a mean of 5.3 points compared to conventional skin markers (98.0 vs. 92.7), a statistically significant difference (p < 0.01, Wilcoxon Test). For surface matching values > 95%, ≥ 3 clips coincided in 99.7% of the determinations and all markers coincided in 92.5%. For surface matching rates > 90%, the location of ≥ 3 clips coincided in 99.55% of determinations.

Conclusions

SGRT improves patient positioning accuracy compared to skin markers. Optimal breast SGRT can accurately verify the localisation of the tumour bed, ensuring matching with ≥ 3 surgical clips. SGRT can eliminate unwanted radiation from IGRT verification systems.

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Acknowledgements

The authors would like to thank PHD Daniel Bautista Rentero for assistance with the statistical analysis and Bradley Londres for his invaluable assistance in editing and improving the manuscript.

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Authors and Affiliations

  1. Department of Radiation Oncology, ERESA, Hospital General Universitario de Valencia (CHGUV), Avenida Tres Cruces, No. 2, 46014, Valencia, Spain

    A. González-Sanchis, J. C. Gordo-Partearroyo, T. Piñeiro-Vidal & J. L. López-Torrecilla

  2. Department of Radiophysics, ERESA, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain

    L. Brualla-González & T. García-Hernandez

  3. Department of Surgery, Hospital General Universitario de Valencia (CHGUV), Valencia, Spain

    C. Fuster-Diana

Authors
  1. A. González-Sanchis
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  2. L. Brualla-González
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  3. C. Fuster-Diana
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  4. J. C. Gordo-Partearroyo
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  5. T. Piñeiro-Vidal
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  6. T. García-Hernandez
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  7. J. L. López-Torrecilla
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Corresponding author

Correspondence to A. González-Sanchis.

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Conflict of interest

No current or potential conflicts of interest exist with regard to this study. The authors have no financial and personal relationship with other persons or organizations that could inappropriately influence their work.

Ethical approval

This study was approved by the hospital ethics committee and conducted in accordance with the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all patients prior to participation.

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González-Sanchis, A., Brualla-González, L., Fuster-Diana, C. et al. Surface-guided radiation therapy for breast cancer: more precise positioning. Clin Transl Oncol 23, 2120–2126 (2021). https://doi.org/10.1007/s12094-021-02617-6

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  • DOI: https://doi.org/10.1007/s12094-021-02617-6

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