Rectal motion can reduce CTV coverage and increase rectal dose during prostate radiotherapy: A daily cone-beam CT study.
Authors
Sripadam, RajStratford, 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
Show full item recordAbstract
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 OncolJournal
Radiotherapy and OncologyDOI
10.1016/j.radonc.2008.07.031PubMed ID
18783839Type
ArticleLanguage
enISSN
0167-8140ae974a485f413a2113503eed53cd6c53
10.1016/j.radonc.2008.07.031
Scopus Count
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