TY - JOUR A1 - Gröger, Christian A1 - Hautmann, Matthias G. A1 - Löschel, Rainer A1 - Repp, Natalia A1 - Kölbl, Oliver A1 - Dobler, Barbara T1 - Re-irradiation of spinal column metastases by IMRT: Impact of setup errors on the dose distribution JF - Radiation Oncology N2 - Background This study investigates the impact of an automated image guided patient setup correction on the dose distribution for ten patients with in-field IMRT re-irradiation of vertebral metastases. Methods 10 patients with spinal column metastases who had previously been treated with 3D-conformal radiotherapy (3D-CRT) were simulated to have an in-field recurrence. IMRT plans were generated for treatment of the vertebrae sparing the spinal cord. The dose distributions were compared for a patient setup based on skin marks only and a Cone Beam CT (CBCT) based setup with translational and rotational couch corrections using an automatic robotic image guided couch top (Elekta - HexaPOD™ IGuide® - system). The biological equivalent dose (BED) was calculated to evaluate and rank the effects of the automatic setup correction for the dose distribution of CTV and spinal cord. Results The mean absolute value (± standard deviation) over all patients and fractions of the translational error is 6.1 mm (±4 mm) and 2.7° (±1.1 mm) for the rotational error. The dose coverage of the 95% isodose for the CTV is considerable decreased for the uncorrected table setup. This is associated with an increasing of the spinal cord dose above the tolerance dose. Conclusions An automatic image guided table correction ensures the delivery of accurate dose distribution and reduces the risk of radiation induced myelopathy. KW - CBCT KW - Setup error KW - IGRT KW - IMRT KW - Spinal metastasis Y1 - 2013 U6 - https://doi.org/10.1186/1748-717X-8-269 VL - 8 IS - 269 PB - BMC, Part of Springer Nature ER -