The contribution of on-line correction for rotational organ motion in image-guided radiotherapy of the bladder and prostate

Redpath, Anthony Thomas; Wright, Pauliina; Muren, L.P.

doi:10.1080/02841860802263232

Cited by 16 publications

(9 citation statements)

References 19 publications

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“…Image guidance for daily localisation is becoming increasingly used in conjunction with advanced delivery techniques such as intensity-modulated radiation therapy [1][2][3][4][5][6][7][8][9][10][11]. Pre-treatment imaging facilitates dose escalation and organ at risk (OAR) sparing through a reduction in the planning target volume (PTV) margin customised to account for daily variation in patient anatomy and set-up [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30].…”

mentioning

confidence: 99%

Schedule for CT image guidance in treating prostate cancer with helical tomotherapy

Beldjoudi

Yartsev²,

Battista³

et al. 2010

BJR

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The aim of this study was to determine the effect of reducing the number of image guidance sessions and patient-specific target margins on the dose distribution in the treatment of prostate cancer with helical tomotherapy. 20 patients with prostate cancer who were treated with helical tomotherapy using daily megavoltage CT (MVCT) imaging before treatment served as the study population. The average geometric shifts applied for set-up corrections, as a result of co-registration of MVCT and planning kilovoltage CT studies over an increasing number of image guidance sessions, were determined. Simulation of the consequences of various imaging scenarios on the dose distribution was performed for two patients with different patterns of interfraction changes in anatomy. Our analysis of the daily set-up correction shifts for 20 prostate cancer patients suggests that the use of four fractions would result in a population average shift that was within 1 mm of the average obtained from the data accumulated over all daily MVCT sessions. Simulation of a scenario in which imaging sessions are performed at a reduced frequency and the planning target volume margin is adapted provided significantly better sparing of organs at risk, with acceptable reproducibility of dose delivery to the clinical target volume. Our results indicate that four MVCT sessions on helical tomotherapy are sufficient to provide information for the creation of personalised target margins and the establishment of the new reference position that accounts for the systematic error. This simplified approach reduces overall treatment session time and decreases the imaging dose to the patient.

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confidence: 99%

Schedule for CT image guidance in treating prostate cancer with helical tomotherapy

Beldjoudi

Yartsev²,

Battista³

et al. 2010

BJR

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“…Various adaptive strategies have been described by several groups including ‘PTV of the day’ selection, isocentre shifts and corrections for translational and rotational motion [ 12 , 14 , 37 , 38 ]. Our daily image-guidance with CBCT and soft tissue match is unique with no previously published IMRT series utilising this approach.…”

Section: Discussionmentioning

confidence: 99%

Promising results with image guided intensity modulated radiotherapy for muscle invasive bladder cancer

et al. 2015

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AimTo describe the feasibility of image guided intensity modulated radiotherapy (IG-IMRT) using daily soft tissue matching in the treatment of bladder cancer.MethodsTwenty-eight patients with muscle-invasive carcinoma of the bladder were recruited to a protocol of definitive radiation using IMRT with accelerated hypofractionation with simultaneous integrated boost (SIB). Isotropic margins of .5 and 1 cm were used to generate the high risk and intermediate risk planning target volumes respectively. Cone beam CT (CBCT) was acquired daily and a soft tissue match was performed. Cystoscopy was scheduled 6 weeks post treatment.ResultsThe median age was 83 years (range 58-92). Twenty patients had stage II or III disease, and eight were stage IV. Gross disease received 66 Gy in 30 fractions in 11 patients (ten with concurrent chemotherapy) or 55 Gy in 20 fractions for those of poorer performance status or with palliative intent. All patients completed radiation treatment as planned. Three patients ceased chemotherapy early due to toxicity. Six patients (21 %) had acute Grade ≥ 2 genitourinary (GU) toxicity and six (21 %) had acute Grade ≥ 2 gastrointestinal (GI) toxicity. Five patients (18 %) developed Grade ≥2 late GU toxicity and no ≥2 late GI toxicity was observed.Nineteen patients underwent cystoscopy following radiation, with complete response (CR) in 16 cases (86 %), including all patients treated with chemoradiotherapy. Eight patients relapsed, four of which were local relapses. Of the patients with local recurrence, one underwent salvage cystectomy. For patients treated with definitive intent, freedom from locoregional recurrence (FFLR) and overall survival (OS) was 90 %/100 % for chemoradiotherapy versus 86 %/69 % for radiotherapy alone.ConclusionIG- IMRT using daily soft tissue matching is a feasible in the treatment of bladder cancer, enabling the delivery of accelerated synchronous integrated boost with good early local control outcomes and low toxicity.

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“…We chose to correct for translational errors alone and excluded rotational variations from our study. This was primarily to minimise complexity and time but was also done on the basis of reports that rotational errors are of lesser significance [9,14,26].…”

Section: Discussionmentioning

confidence: 99%

Clinical commissioning of online seed matching protocol for prostate radiotherapy

Duffton¹,

McNee²,

Muirhead³

et al. 2012

BJR

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The contribution of on-line correction for rotational organ motion in image-guided radiotherapy of the bladder and prostate

Cited by 16 publications

References 19 publications

Schedule for CT image guidance in treating prostate cancer with helical tomotherapy

Schedule for CT image guidance in treating prostate cancer with helical tomotherapy

Promising results with image guided intensity modulated radiotherapy for muscle invasive bladder cancer

Clinical commissioning of online seed matching protocol for prostate radiotherapy

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