Maximizing rectal dose sparing with hydrogel: A retrospective planning study
| Autor: | Howard Pai, Owen Paetkau, Isabelle M. Gagne, Abraham Alexander, Jacqueline Lam, Jennifer Goulart |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Organs at Risk 87.55.dk medicine.medical_treatment Urinary system 87.55.de Urinary Bladder rectal sparing Rectum 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Planning study Medicine Radiation Oncology Physics Humans Radiology Nuclear Medicine and imaging EBRT Instrumentation 87.55.d Dose sparing Retrospective Studies Radiation prostate business.industry Radiotherapy Planning Computer-Assisted Prostatic Neoplasms Hydrogels Radiotherapy Dosage medicine.disease Radiation therapy medicine.anatomical_structure 030220 oncology & carcinogenesis SpaceOAR Implant Radiotherapy Intensity-Modulated hydrogel business Nuclear medicine Organ Sparing Treatments |
| Zdroj: | Journal of Applied Clinical Medical Physics |
| ISSN: | 1526-9914 |
| Popis: | External beam radiation therapy for prostate cancer can result in urinary, sexual, and rectal side effects, often impairing quality of life. A polyethylene glycol‐based product, SpaceOAR© hydrogel (SOH), implanted into the connective tissue between the prostate gland and rectum can significantly reduce the dose received by the rectum and hence risk of rectal toxicity. The optimal way to manage the hydrogel and rectal structures for plan optimization is therefore of interest. In 13 patients, computerized tomography (CT) scans were taken pre‐ and post‐SpaceOAR© implant. A prescription of 60 Gy in 20 fractions was planned on both scans. Six treatment plans were produced per anonymized dataset using either a structure of rectum plus the hydrogel, termed composite rectum wall (CRW), or rectal wall (RW) as an inverse optimization structure and intensity modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) as a treatment technique. Dose‐volume histogram metrics were compared between plans to determine which optimization structure and treatment technique offered the maximum rectal dose sparing. RW structures offered a statistically significant decrease in rectal dose over CRW structures, whereas the treatment technique (IMRT vs VMAT) did not significantly affect the rectal dose. There was improvement seen in bladder and penile bulb dose when VMAT was used as a treatment technique. Overall, treatment plans using the RW optimization structure offered the lowest rectal dose while VMAT treatment technique offered the lowest bladder and penile bulb dose. |
| Databáze: | OpenAIRE |
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