Verification of surface‐guided radiation therapy (SGRT) alignment for proton breast and chest wall patients by comparison to CT‐on‐rails and kV‐2D alignment

• Published in: Journal of applied clinical medical physics 2024-02, Vol.25 (2), p.e14263-n/a
• Main Authors: Zhao, Hui, Sarkar, Vikren, St James, Sara, Paxton, Adam, Su, Fan‐Chi Frances, Price, Ryan G., Dial, Christian, Poppe, Matthew, Gaffney, David, Salter, Bill
• Format: Article
• Language: English
• Subjects: Breast cancer; Chronic obstructive pulmonary disease; CTOR; kV‐2D; Lymphatic system; Patients; proton; Radiation therapy; SGRT; Simulation; Technical Note; Technical Notes
• ISSN: 1526-9914; 1526-9914
• DOI: 10.1002/acm2.14263

Background Surface‐guided radiation therapy (SGRT) systems have been widely installed and utilized on linear accelerators. However, the use of SGRT with proton therapy is still a newly developing field, and published reports are currently very limited. Purpose To assess the clinical application and alignment agreement of SGRT with CT‐on‐rails (CTOR) and kV‐2D image‐guided radiation therapy (IGRT) for breast treatment using proton therapy. Methods Four patients receiving breast or chest wall treatment with proton therapy were the subjects of this study. Patient #1′s IGRT modalities were a combination of kV‐2D and CTOR. CTOR was the only imaging modality for patients #2 and #3, and kV‐2D was the only imaging modality for patient #4. The patients’ respiratory motions were assessed using a 2‐min surface position recorded by the SGRT system during treatment. SGRT offsets reported after IGRT shifts were recorded for each fraction of treatment. The agreement between SGRT and either kV‐2D or CTOR was evaluated. Results The respiratory motion amplitude was