Rectal motion can reduce CTV coverage and increase rectal dose during prostate radiotherapy: A daily cone-beam CT study.

2.50
Hdl Handle:
http://hdl.handle.net/10541/69740
Title:
Rectal motion can reduce CTV coverage and increase rectal dose during prostate radiotherapy: A daily cone-beam CT study.
Authors:
Sripadam, Raj; Stratford, Julia; Henry, Ann M; Jackson, Andrew; Moore, Christopher J; Price, Patricia M
Abstract:
BACKGROUND AND PURPOSE: Daily on-treatment verification cone-beam CT (CBCT) was used to study the effect of rectal motion on clinical target volume (CTV) coverage during prostate radiotherapy. MATERIAL AND METHODS: CBCT scans were acquired from 15 patients immediately after daily treatment. From these images, the rectum was contoured allowing the analysis of rectal volume cross-sectional area (CSA) and the determination of rectal dose. Rectal wall motion was quantified as a surrogate measure of prostate displacement and CTV coverage was subjectively assessed. RESULTS: Rectal volume decreased over the treatment course in 13 patients (P<0.001). Rectal wall regions corresponding to the prostate base displayed the greatest motion; larger displacements were seen in patients with larger rectal planning volumes. CTV coverage was inadequate, at the prostate base only, in 38% of the fractions delivered to 4/7 patients with a large rectum at planning (>100 cm(3)). In patients with small rectum at planning (<50 cm(3)) up to 25% more rectal volume than predicted was included in the high-dose region. CONCLUSIONS: Rectal motion during treatment in prostate cancer patients has implications for CTV coverage and rectal dose. Measures to ensure consistency in daily rectal volume or image-guided strategies should be considered.
Affiliation:
Clatterbridge Centre for Oncology, Bebington, Wirral, UK.
Citation:
Rectal motion can reduce CTV coverage and increase rectal dose during prostate radiotherapy: A daily cone-beam CT study. 2009, 90 (3):312-7 Radiother Oncol
Journal:
Radiotherapy and Oncology
Issue Date:
Mar-2009
URI:
http://hdl.handle.net/10541/69740
DOI:
10.1016/j.radonc.2008.07.031
PubMed ID:
18783839
Type:
Article
Language:
en
ISSN:
0167-8140
Appears in Collections:
All Christie Publications ; Christie Medical Physics and Engineering Research; Clinical Oncology; Academic Department of Radiation Oncology - ADRO

Full metadata record

DC FieldValue Language
dc.contributor.authorSripadam, Raj-
dc.contributor.authorStratford, Julia-
dc.contributor.authorHenry, Ann M-
dc.contributor.authorJackson, Andrew-
dc.contributor.authorMoore, Christopher J-
dc.contributor.authorPrice, Patricia M-
dc.date.accessioned2009-06-04T14:39:37Z-
dc.date.available2009-06-04T14:39:37Z-
dc.date.issued2009-03-
dc.identifier.citationRectal motion can reduce CTV coverage and increase rectal dose during prostate radiotherapy: A daily cone-beam CT study. 2009, 90 (3):312-7 Radiother Oncolen
dc.identifier.issn0167-8140-
dc.identifier.pmid18783839-
dc.identifier.doi10.1016/j.radonc.2008.07.031-
dc.identifier.urihttp://hdl.handle.net/10541/69740-
dc.description.abstractBACKGROUND AND PURPOSE: Daily on-treatment verification cone-beam CT (CBCT) was used to study the effect of rectal motion on clinical target volume (CTV) coverage during prostate radiotherapy. MATERIAL AND METHODS: CBCT scans were acquired from 15 patients immediately after daily treatment. From these images, the rectum was contoured allowing the analysis of rectal volume cross-sectional area (CSA) and the determination of rectal dose. Rectal wall motion was quantified as a surrogate measure of prostate displacement and CTV coverage was subjectively assessed. RESULTS: Rectal volume decreased over the treatment course in 13 patients (P<0.001). Rectal wall regions corresponding to the prostate base displayed the greatest motion; larger displacements were seen in patients with larger rectal planning volumes. CTV coverage was inadequate, at the prostate base only, in 38% of the fractions delivered to 4/7 patients with a large rectum at planning (>100 cm(3)). In patients with small rectum at planning (<50 cm(3)) up to 25% more rectal volume than predicted was included in the high-dose region. CONCLUSIONS: Rectal motion during treatment in prostate cancer patients has implications for CTV coverage and rectal dose. Measures to ensure consistency in daily rectal volume or image-guided strategies should be considered.en
dc.language.isoenen
dc.subjectProstate Canceren
dc.subjectMarginsen
dc.subject.meshAged-
dc.subject.meshCone-Beam Computed Tomography-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMotion-
dc.subject.meshProstatic Neoplasms-
dc.subject.meshRadiotherapy Planning, Computer-Assisted-
dc.subject.meshRectum-
dc.titleRectal motion can reduce CTV coverage and increase rectal dose during prostate radiotherapy: A daily cone-beam CT study.en
dc.typeArticleen
dc.contributor.departmentClatterbridge Centre for Oncology, Bebington, Wirral, UK.en
dc.identifier.journalRadiotherapy and Oncologyen

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