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• W3022820483 abstract "Fractionated stereotactic radiotherapy (SRT) requires extremely precise and reproducible immobilization of the patient’s head. This study compared the efficacy of two commonly used forms of immobilization used for SRT. Two routinely used methods of immobilization, which differ in their approach to reproduce head position from day-to-day are the Gill-Thomas-Cosman (GTC) frame and the BrainLab thermoplastic mask. The GTC frame fixates on the patient upper dentition and thus is in direct mechanical contact with the cranium. The BrainLab mask is a two-part masking system custom fitted to the front and back of patient’s head. After patients signed an IRB-approved informed consent form, eligible patients were randomized to either GTC frame or mask for their course of SRT. Patients were treated as per standard procedure; however, prior to each treatment a set of orthogonal digital kV images (ExacTrac, BrainLabAB, Germany) was taken. These images were fused with reference digitally reconstructed radiographs obtained from treatment planning CT to yield lateral, longitudinal and vertical deviations of isocenter and head rotations about respective axes. The primary endpoint of the study was to compare the two systems with respect to mean and standard deviations (SDs) using the distance to isocenter measure. A total of 68 pts have been enrolled; positioning data for 37 patients (19 frame patients and 18 mask patients) are currently analyzable. The means, the distance measures and their SDs (in mm) for both immobilization systems are shown in Table 1.Tabled 1LatLongVertDistanceLat AngleLong AngleVert AngleGTC FrameMean−0.340.55−0.451.93−0.26−0.270.01SD1.081.281.120.980.740.990.69BrainLab MaskMean−0.020.410.003.19−0.240.070.18SD1.163.321.372.062.371.261.57 Open table in a new tab Table 1. The mean lateral (lat), longitudinal (long) and vertical (vert) shifts and distances [mm], and rotations [deg] with their respective SDs for frame and mask. Positive mean shifts indicate shifts to the patient left, superior and anterior. A mixed-effects linear regression and two-tiled t-test were used to compare the distance measure for both the systems. There was a statistically significant (p=0.004) difference between mean distances for these systems, suggesting that the GTC frame was more accurate. Both immobilization techniques were highly effective, but the GTC frame was a more accurate immobilization system as determined by analyzing distance measurements obtained using ExacTrac system, particularly in the longitudinal dimension. To optimize the accuracy of SRT, daily kV image guidance is recommended with either immobilization system." @default.
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• W3022820483 date "2006-11-01" @default.
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• W3022820483 title "2892" @default.
• W3022820483 doi "https://doi.org/10.1016/j.ijrobp.2006.07.1311" @default.
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