To Assess the Effect of BMI on Patient Setup Reproducibility in Hypofractionation of Breast Cancer to Establish an Imaging Protocol

Z. Mulla, R. Hashem, Hiba Taha, Maria Coogen, Majd Alharthy, H. Hijazi
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Abstract

Objectives: To analyze the setup accuracy among patients treated for breast cancer with hypofractionation radiation therapy (HFRT) regimen (five fractions instead of 15-16 fractions in standard regimen) and predict the necessity of performing the setup imaging in the 4th and 5th fractions as a function of setup accuracy in the first three fractions. Methods: This retrospective study reviewed setup displacements in each direction (lateral, longitudinal, and vertical) for 51 women with breast cancer treated with HFRT at the Radiation Therapy Unit between September 2020 and May 2022. Besides the five fractions (#1– # 5), the mean setup error was computed for the first three fractions (AVG-III) for each direction. Setup accuracy rates were computed for each direction and fraction as the percentage of fractions with setup error ≤ 0.5 cm. The correlations of #1, #2, #3, and AVG-III setup errors and their value in indicating #4 and #5 setup error and accuracy were analyzed using Pearson's coefficient and Receiver Operating Characteristics (ROC) curve, respectively. Furthermore, the effect of body mass index (BMI) on setup reproducibility was analyzed using logistic regression Result: The mean (SD) age of the participants was 54.41 (11.46) years. There was a high percentage of overweight (25.5%) and obese (53.0%). The mean setup error was 0.05) and #5 (r = -0.128–0.254; p>0.05) within any of the first three fractions or AVG-III, in any of the directions. In the ROC curve, only #5 accuracy was indicated by #3 in the longitudinal direction (AUC=0.89, p=0.025). BMI was only associated with inaccurate setup for fraction #3 in the lateral direction, in a positive relationship (OR=1.15, 95% CI = 1.01–1.30; p=0.031). Conclusion: Setup accuracy in the first fractions of HFRT does not predict accuracy in the two last fractions nor is predicted by the patient’s BMI. Consequently, women with breast cancer treated with HFRT require daily imaging for optimal setup before each radiotherapy fraction.
评估BMI对乳腺癌低分割患者设置可重复性的影响,以建立影像学方案
目的:分析低分割放疗(HFRT)方案治疗乳腺癌患者的设置准确性(5个分数而不是标准方案的15-16个分数),并预测在第4和第5个分数进行设置成像的必要性,作为前三个分数设置准确性的函数。方法:本回顾性研究回顾了2020年9月至2022年5月期间在放射治疗部门接受HFRT治疗的51名乳腺癌妇女在各个方向(横向、纵向和垂直)的装置移位。除了五个分数(#1 - # 5)外,还计算了每个方向的前三个分数(AVG-III)的平均设置误差。以设置误差≤0.5 cm的分数百分比计算每个方向和分数的设置准确率。分别使用Pearson系数和受试者工作特征(ROC)曲线分析#1、#2、#3和AVG-III设置误差的相关性及其对#4和#5设置误差和准确性的指示值。此外,采用logistic回归分析体重指数(BMI)对设置可重复性的影响。结果:参与者的平均(SD)年龄为54.41(11.46)岁。超重(25.5%)和肥胖(53.0%)的比例较高。平均设置误差为0.05)和#5 (r = -0.128-0.254;p>0.05)在前三个部分或AVG-III中,在任何方向上。在ROC曲线上,纵向上#3只表示#5的准确度(AUC=0.89, p=0.025)。BMI仅与侧位分数#3的不准确设置相关,呈正相关(OR=1.15, 95% CI = 1.01-1.30;p = 0.031)。结论:HFRT第一部分的设置准确性不能预测最后两个部分的准确性,也不能由患者的BMI预测。因此,接受HFRT治疗的乳腺癌妇女需要在每次放疗前进行每日成像以确定最佳设置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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