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The aim of radiation therapy (RT) is to reliably maximize the dose to the target while minimizing the toxicity to the normal tissues. Therefore, daily treatment setup is considered as a critical requirement in RT for an accurate dose delivery. The planning target volume (PTV) is defined as the clinical target volume (CTV) plus a margin to account for patient positioning uncertainties, beam alignment and organ motion (i.e. setup margin and internal margin). Setup margins have a direct effect on the coverage of target volume. Thus, these should be optimized to prevent inadvertent irradiation of organ at risks (OARs) [1,2]. Setup uncertainties can be divided into two categories: systematic errors and random errors.Whereas the random errors blur the dose distribution, the systematic component of errors leads to a shift of the cumulative dose distribution relative to the target. The systematic errors are reproducible consistent errors, occurring in the same direction and magnitude but random (day-to-day) errors can vary in direction, magnitude and are unpredictable. The systematic errors in contrast to the random errors are more dangerous because they affect all treatment sessions. Thus, systematic errors may lead to the recurrence of the tumor or serious damage in normal organs [3]. Abstract

cancer therapy and oncology international journal

Evaluation of Patient setup Accuracy and Determination of Optimal Setup Margin for External Beam Radiation therapy using Electronic Portal Imaging Device