Тhe effect of cancer patients’ positioning accuracy during radiation therapy sessions using medical linear electron accelerators on the parameters of their individual 3D dose distribution

Due to the rapid development and further improvement of radiation treatment technologies oncologists have an opportunity to precisely deliver individual dose distributions to the tumor, minimizing the doses obtained by critical organs and healthy structures. For the correct and successful application of these complex methods of radiation therapy, it was necessary to enforce the requirements for the technical and dosimetric parameters of the radiotherapy equipment. The purpose of the research is to determine the magnitude of the possible error for patients’ positioning during their radiotherapy treatments using medical linear accelerators by modeling the impact of the patient’s body on the treatment couch. To determine the values of a possible error, the authors have considered the design and characteristics of a typical treatment couch, developed a model of the “average” patient’s body (phantom), which allowed changing the load to the treatment couch with a step of 1 kg. The position parameters of treatment couches were determined for the main types of localization of radiation therapy for malignant tumors: head and neck tumors, breast tumors and pelvic tumors. Numerical values of the treatment coach deviations from prescribed horizontal position were experimentally established for a load from 40 to 180 kg for a treatment couch used at the N.N. Alexandrov National Cancer Centre of Belarus. Based on the obtained experimental data, the necessity to correct the patient's treatment conditions at the stage of treatment planning were confirmed in order to ensure the delivery accuracy of individual dose distributions as required by the radiation therapy protocols. Authors stated that an analysis of the dependence of the deviations in the dose delivered to the patients on the deviation of the radiotherapy table from its horizontal position should be carried out for each radiotherapy table used in clinical practice. The development and implementation of a mechanism that will allow considering this information when choosing the parameters of the patient’s treatment session and prescribing the dose for any localization of malignant neoplasms is needed.

linear accelerator, treatment couch, phantom, patient’s treatment position

1. Oceanov A.I. Moiseeva P.I., Levina L.F., Evmenenko A.A., Ipatiy T.B., Sukonko O.G. [Cancer in Belarus: figures and facts. Analysis of the data of the Belarusian Cancer Register for 2009–2018]. Minsk: National Library of Belarus; 2019. (In Russ.)

2. Klimanov V.A. [Radiobiological and dosimetric planning of radiation and radionuclide therapy. P. 1. Radiobiological basis of radiation therapy. Radiobiological and dosimetric planning of remote radiation therapy with braking and gamma radiation beams]. Moscow: NRNU MEPhI; 2011. (In Russ.)

3. Tepper J., Foote R., Michalski J. Clinical radiation oncology. 5th Ed. Elsevier; 2020.

4. Tarutin. I.G. [The use of linear electron accelerators in high-tech radiation therapy]. Minsk: Belaruskaya Navuka; 2015. (In Russ.)

5. Practical issues in treating heavy patients on a LINAC treatment couch. Journal of applied clinical medical physics. 2005;6(1):45-56.

6. Sharuho I.N. [Belarusians in the anthropological and ethnic space]. Pskovskiy Regionalny Jurnal = Pskov Regional Journal. 2008;1:142-152. (In Russ.)