Program Information
Estimating the Minimum Number of Patients Required to Estimate the Required Planning Target Volume Margins for Prostate Glands
M Bakhtiari*, J Schmitt , M Sarfaraz , C Osik , RadAmerica, LLC--MedStar Health, Baltimore,, MD
Presentations
SU-E-T-364 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall
Purpose: To establish a minimum number of patients required to obtain statistically accurate Planning Target Volume (PTV) margins for prostate Intensity Modulated Radiation Therapy (IMRT).
Methods: A total of 320 prostate patients, consisting of a total number of 9311 daily setups, were analyzed. These patients had gone under IMRT treatments. Daily localization was done using the skin marks and the proper shifts were determined by the CBCT to match the prostate gland. The Van Herk formalism is used to obtain the margins using the systematic and random setup variations. The total patient population was divided into different grouping sizes varying from 1 group of 320 patients to 64 groups of 5 patients. Each grouping was used to determine the average PTV margin and its associated standard deviation.
Results: Analyzing all 320 patients lead to an average Superior-Inferior margin of 1.15 cm. The grouping with 10 patients per group (32 groups) resulted to an average PTV margin between 0.6-1.7 cm with the mean value of 1.09 cm and a standard deviation (STD) of 0.30 cm. As the number of patients in groups increases the mean value of average margin between groups tends to converge to the true average PTV of 1.15 cm and STD decreases. For groups of 20, 64, and 160 patients a Superior-Inferior margin of 1.12, 1.14, and 1.16 cm with STD of 0.22, 0.11, and 0.01 cm were found, respectively. Similar tendency was observed for Left-Right and Anterior-Posterior margins.
Conclusion: The estimation of the required margin for PTV strongly depends on the number of patients studied. According to this study at least ~60 patients are needed to calculate a statistically acceptable PTV margin for a criterion of STD < 0.1 cm. Numbers greater than ~60 patients do little to increase the accuracy of the PTV margin estimation.
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