Calculation of planning target volume margins using the van Herk, Stroom and ICRU methods in patients with gastric cancer


Author(s): Agnieszka Namysł-Kaletka, Andrzej Tukiendorf, Jerzy Wydmański

The aim. The aim of this paper was to compare the methods of specifying margins in
patients with gastric cancer.
Material and methods. The material included 57 patients with gastric cancer during
chemoradiotherapy in whom the positioning in the therapeutic system was verified using
2 kV images prior to each radiotherapy fraction. Subsequently, shifts in three axes were
assessed. Based on the shifts obtained, systematic and random errors were calculated
in given axes and margins were specified using the van Herk, Stroom and ICRU 62
Results. The margins resulting from the interfraction motion based of the van Herk,
Stroom and ICRU formulae were as follows: 9 mm, 7 mm and 6 mm in the lateral axis,
16 mm, 14 mm and 11 mm in the craniocaudal axis as well as 8 mm, 7 mm and 5 mm
in the anteroposterior axis, respectively for each formula. The lowest percentage of shifts
that were greater than the calculated margin was observed in the van Herk method (1.5%
in the lateral axis, 3.3% in the craniocaudal axis and 1.9% in the anteroposterior axis).
Conclusions. Based on the material investigated, the margin recommended for centers
in which daily patient position verification is not possible is the one calculated with
the use of the van Herk formula.

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Editors List

  • Andrzej Zdziennicki

    Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)

  • Krzysztof Urbanski

    Head of the Oncology Gynecology Clinic, Oncology Center - Instytut im. Maria Sklodowska Curie, Department in Krakow (Krakow, Poland)

  • Andrzej Szawlowski

    Klinika Nowotworow Gornego Odcinka Uklad Digestii, Oncology Center - Institute (Warsaw, Poland)

  • Skowronska-Gardas

    Department of Radiotherapy, Oncology Center-Institute (Warsaw, Poland)

  • Serban-Dan Costa

    Head of the Obstetrics and Gynecology Clinic of the University of Otto von Guericke (Magdeburg, Germany)