Defining the Clinical Target Volume for Bladder Cancer Radiotherapy Treatment Planning

Jenkins, Peter; Anjarwalla, Salim; Gilbert, Hugh; Kinder, R. B.

doi:10.1016/j.ijrobp.2009.01.063

Cited by 22 publications

(9 citation statements)

References 27 publications

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“…A quantitative pathologic assessment of subclinical tumor invasion from primary tumor or metastatic lymph nodes into adjacent tissues for planning external-beam radiotherapy has been performed successfully for some cancers, including head-and-neck, lung, skin, prostate, and bladder cancers [14-22]. There are few relevant data available for hepatocellular carcinoma [23].…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma: Definition of clinical target volume for radiotherapy

et al. 2010

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BackgroundTo define the clinical target volume (CTV) for radiotherapy in patients with hepatocellular carcinoma (HCC).MethodsA prospective study was conducted to histologically evaluate the presence and the distance of microscopic extension (ME) for resected HCC on the basis of examination of whole-mount preparations of carcinoma tissue sections.ResultsA total of 380 whole-mount slides prepared from tumor samples of 76 patients with HCC were examined. Patients with elevated pretreatment AFP levels exhibited higher risk of ME as compared to those with normal pretreatment AFP levels (93.9% vs. 69.8%, P < 0.01). ME positivity was 16.7% for Grade 1, 79.1% for Grade 2, and 96.3% for Grade 3 tumors (P < 0.01). The mean distance of ME was 0.0 ± 0.1 mm (range 0-0.2 mm) for Grade 1, 0.9 ± 0.9 mm (range 0-4.5 mm) for Grade 2, and 1.9 ± 1.9 mm (range 0-8.0 mm) for Grade 3 tumors (P < 0.01).ConclusionsThe CTV margins for tumor Grades 1, 2, and 3 HCC, are recommended to be 0.2 mm, 4.5 mm, and 8.0 mm beyond the gross tumor margin, respectively, to account for possible ME of the tumors in all patients.

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma: Definition of clinical target volume for radiotherapy

et al. 2010

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“…Jenkins et al found that the depth of tumor infiltration into the bladder wall depends on extravesical stranding visible on a planning CT-scan. 19 GTV delineation on fused cystoscopy and CT images could, therefore, substantially improve the accuracy of bladder tumor delineation. More precise delineation combined with precise position verification during treatment, which is also possible using an online lipiodol correction protocol, 12 paves the way for smaller margins and possibly dose escalation, which might improve treatment outcome of bladder cancer radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Fusion of planning CT and cystoscopy images for bladder tumor delineation: A feasibility study

et al. 2013

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“…Jenkins et al (9) have recommended that the CTV boost should include the tumor bed plus a 10-mm margin in patients with radiological evidence of extravesical disease. In patients with no evidence of extravesical disease, they have suggested that the CTV boost should include the tumor bed plus a 6-mm margin.…”

Section: Introductionmentioning

confidence: 99%

Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To evaluate Lipiodol as a liquid, radio-opaque fiducial marker for image--guided radiation therapy (IGRT) for bladder cancer. Materials and Methods:Between 2011 and 2012, 5 clinical T2a-T3b N0 M0 stage II-III bladder cancer patients were treated with maximal transurethral resection of a bladder tumor (TURBT) and image-guided radiation therapy (IGRT) to 64.8 Gy in 36 fractions ± concurrent weekly cisplatin-based or gemcitabine chemotherapy. Ten to 15mL Lipiodol, using 0.5mL per injection, was injected into bladder submucosa circumferentially around the entire periphery of the tumor bed immediately following maximal TURBT.The authors looked at inter-observer variability regarding the size and location of the tumor bed (CTV boost ) on computed tomography scans with versus without Lipiodol.Results: Median follow-up was 18 months. Lipiodol was visible on every orthogonal two-dimensional kV portal image throughout the entire, 7-week course of IGRT. There was a trend towards improved inter-observer agreement on the CTV boost with Lipiodol (p = 0.06). In 2 of 5 patients, the tumor bed based upon Lipiodol extended outside a planning target volume that would have been treated with a radiation boost based upon a cystoscopy report and an enhanced computed tomography (CT) scan for staging. There was no toxicity attributable to Lipiodol. Conclusions: Lipiodol constitutes a safe and effective fiducial marker that an urologist can use to demarcate a tumor bed immediately following maximal TURBT. Lipiodol decreases inter-observer variability in the definition of the extent and location of a tumor bed on a treatment planning CT scan for a radiation boost.

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Defining the Clinical Target Volume for Bladder Cancer Radiotherapy Treatment Planning

Cited by 22 publications

References 27 publications

Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma: Definition of clinical target volume for radiotherapy

Prospective evaluation of microscopic extension using whole-mount preparation in patients with hepatocellular carcinoma: Definition of clinical target volume for radiotherapy

Fusion of planning CT and cystoscopy images for bladder tumor delineation: A feasibility study

Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer

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