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

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    Authors
    Sripadam, Raj
    Stratford, Julia
    Henry, Ann M
    Jackson, Andrew
    Moore, Christopher J
    Price, Patricia M
    Affiliation
    Clatterbridge Centre for Oncology, Bebington, Wirral, UK.
    Issue Date
    2009-03
    
    Metadata
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    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.
    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
    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
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radonc.2008.07.031
    Scopus Count
    Collections
    All Christie Publications
    Christie Medical Physics and Engineering Research
    Clinical Oncology
    Academic Department of Radiation Oncology - ADRO

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