Residual setup errors towards the heart after image guidance linked with poorer survival in lung cancer patients: do we need stricter IGRT protocols?

Image-guided radiotherapy (IGRT) is widely used but data providing evidence of its direct effect on patient outcome is scarce. We related residual patient setup errors from IGRT data to overall survival for NSCLC. The direction of the residual errors was found to be significant, with patients with residual shifts towards the heart having significantly worse overall survival than those with shifts away from the heart. This result was independently validated in an oesophageal cancer cohort.

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