Individualized planning target volumes for intrafraction motion during hypofractionated intensity-modulated radiotherapy boost for prostate cancer
| Autor: | Jean-Philippe Pignol, Katharina E. Sixel, Geordi Pang, Patrick Cheung, Ewa Szumacher, Gerrit DeBoer, D. Andrew Loblaw, Romeo Tirona, Richard Choo, Gerard Morton |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Cancer Research Movement medicine.medical_treatment Planning target volume Prostate cancer Prostate Humans Medicine Fluoroscopy Radiology Nuclear Medicine and imaging Aged Aged 80 and over Radiation medicine.diagnostic_test business.industry Respiration Prostatic Neoplasms Seminal Vesicles Middle Aged Urination Disorders medicine.disease Radiation therapy medicine.anatomical_structure Oncology Intrafraction motion Dose Fractionation Radiation Intensity modulated radiotherapy Radiotherapy Conformal business Nuclear medicine Fiducial marker |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 62:418-425 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2004.09.051 |
| Popis: | Purpose: The objective of the study was to access toxicities of delivering a hypofractionated intensity-modulated radiotherapy (IMRT) boost with individualized intrafraction planning target volume (PTV) margins and daily online correction for prostate position. Methods and materials: Phase I involved delivering 42 Gy in 21 fractions using three-dimensional conformal radiotherapy, followed by a Phase II IMRT boost of 30 Gy in 10 fractions. Digital fluoroscopy was used to measure respiratory-induced motion of implanted fiducial markers within the prostate. Electronic portal images were taken of fiducial marker positions before and after each fraction of radiotherapy during the first 9 days of treatment to calculate intrafraction motion. A uniform 10-mm PTV margin was used for the first phase of treatment. PTV margins for Phase II were patient-specific and were calculated from the respiratory and intrafraction motion data obtained from Phase I. The IMRT boost was delivered with daily online correction of fiducial marker position. Acute toxicity was measured using National Cancer Institute Common Toxicity Criteria, version 2.0. Results: In 33 patients who had completed treatment, the average PTV margin used during the hypofractionated IMRT boost was 3 mm in the lateral direction, 3 mm in the superior-inferior direction, and 4 mm in the anteroposterior direction. No patients developed acute Grade 3 rectal toxicity. Three patients developed acute Grade 3 urinary frequency and urgency. Conclusions: PTV margins can be reduced significantly with daily online correction of prostate position. Delivering a hypofractionated boost with this high-precision IMRT technique resulted in acceptable acute toxicity. |
| Databáze: | OpenAIRE |
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