Radiation Dose–Volume Effects of the Urinary Bladder

Viswanathan, Akila; Yorke, Ellen; Marks, Lawrence B.; Eifel, Patricia J.; Shipley, William U.

doi:10.1016/j.ijrobp.2009.02.090

Cited by 346 publications

(276 citation statements)

References 57 publications

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“…This was demonstrated dosimetrically herein as the number of daily sessions receiving high rectum or bladder dose was reduced with decrease in margin. Based on previous reports, 1 , 2 , 35 rectum sparing is likely to translate into a decreased rate and level of late GI toxicity. The decrease of dose to the bladder may alleviate GU complications in the setting of standard fractionation and with prostate SBRT, which has shown higher (15.6%) late GU toxicity rate than that (12.6%) of the standard‐fractionated IMRT (36) …”

Section: Discussionmentioning

confidence: 95%

Using daily diagnostic quality images to validate planning margins for prostate interfractional variations

Vassil

Godley

et al. 2016

J Applied Clin Med Phys

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The purpose of this study is to use the same diagnostic‐quality verification and planning CTs to validate planning margin account for residual interfractional variations with image‐guided soft tissue alignment of the prostate. For nine prostate cancer patients treated with IMRT to 78 Gy in 39 fractions, daily verification CT‐on‐rails images of the first seven and last seven fractions false(n=126false) were retrospectively selected for this study. On these images, prostate, bladder, and rectum were delineated by the same attending physician. Clinical plans were created with a margin of 8 mm except for 5 mm posteriorly, referred to as 8/5 mm. Three additional plans were created for each patient with the margins of 6/4 mm, 4/2 mm, and 2 mm uniform. These plans were subsequently applied to daily images and radiation doses were recalculated. The isocenters of these plans were placed according to clinical online shifts, which were based on soft tissue alignment to the prostate. Retrospective offline shifts by aligning prostate contours were compared to online shifts. The resultant daily target dose was analyzed using D99, the percentage of the prescription dose received by 99% of CTV. The percent of bladder volume receiving 65 Gy false(normalV65Gyfalse) and rectum normalV70Gy were also analyzed. After interfractional correction, using CTV normalD99>97%% criteria, 8/5 mm, 6/4 mm, 4/2 mm, and 2 mm planning margins met the CTV dose coverage in 95%, 91%, 65%, and 53% of the 126 fractions with online shifts, and 99%, 98%, 85%, and 68% with offline shifts. The rectum normalV70Gy and bladder normalV65Gy were significantly decreased at each level of margin reduction (p<0.05). With daily diagnostic quality imaging‐guidance, the interfractional planning margin may be reduced from 8/5 mm to 6/4 mm. The residual interfractional uncertainties most likely stem from prostate rotation and deformation.PACS number(s): 87.53.‐j

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Section: Discussionmentioning

confidence: 95%

Using daily diagnostic quality images to validate planning margins for prostate interfractional variations

Vassil

Godley

et al. 2016

J Applied Clin Med Phys

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“…Understanding the impact of dosimetric and clinical factors on urinary symptoms after radiotherapy is crucial to help the decision making process for a more tailored treatment and patient care [2]. Data from RADAR, with a sufficiently large patient cohort and with long follow-up, is suitable for derivation of such evidence.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of lower urinary tract symptoms, sometimes indistinguishable from those related to treatment, is increasing with advancing age [2,31].…”

Section: Discussionmentioning

confidence: 99%

“…Physical doses to each voxel in the dose matrix for each treatment phase were combined to generate EQD2 -the equivalent dose in 2 Gy fractions -using an α/β of 6 Gy [2,21]. Dose bins of 0.1 Gy were used to calculate the dose received by the bladder wall surface using relative surface area of tissue receiving more than a threshold dose.…”

Section: Principal Components Of Bladder Dose-surface Histogrammentioning

confidence: 99%

“…Urinary symptoms following external beam radiotherapy (EBRT) are gaining more importance as they affect more patients than rectal symptoms, especially with dose escalation, despite the use of more conformal treatment techniques [1]. There is currently a lack of rigorous evidence regarding urinary complications [2].…”

Section: Introductionmentioning

confidence: 99%

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Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

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Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72 months. The endpoints assessed were prevalence (grade≥1) at the end of radiotherapy (representing acute symptoms), at 18-, 36-and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade≥2. Impact of factors were assessed using multivariate logistic regression models with correction for over-optimism. Results: Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status. Conclusions:The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact.4

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Intensity-Modulated Radiation Therapy, Proton Therapy, or Conformal Radiation Therapy and Morbidity and Disease Control in Localized Prostate Cancer

Sheets

Goldin²,

Meyer³

et al. 2012

JAMA

403

140

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Radiation Dose–Volume Effects of the Urinary Bladder

Cited by 346 publications

References 57 publications

Using daily diagnostic quality images to validate planning margins for prostate interfractional variations

Using daily diagnostic quality images to validate planning margins for prostate interfractional variations

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Intensity-Modulated Radiation Therapy, Proton Therapy, or Conformal Radiation Therapy and Morbidity and Disease Control in Localized Prostate Cancer

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