The Impact of Varying Volumes in Rectal Balloons on Rectal Dose Sparing in Conformal Radiation Therapy of Prostate Cancer

Abstract

The use of a rectal balloon filled with 60 ml air led to a significantly decreased proportion of the irradiated rectal wall for all CTVs. This volume filled in rectal balloons is therefore recommended for use. In case of irradiation of the prostate without the seminal vesicles, the use of a rectal balloon should be considered carefully concerning the patients' imaginable discomfort using a rectal balloon and a questionable advantage concerning the estimated risk for chronic toxicity.

Target Motion Variability and On-Line Positioning Accuracy during External-Beam Radiation Therapy of Prostate Cancer with an Endorectal Balloon Device

“…We and others have previously shown, that an ERB reduces prostate mobility and the dose of ionizing radiation delivered to the rectal mucosa [7,15,32]. We measured PTV margins in the absence of additional prostate localization techniques except an ERB.…”

“…Interfraction motion can be reduced with positioning devices such as casts or leg holders, fixation devices such as endorectal balloons (ERBs) or spacers [3,14,15,31], by treating only patients with a full bladder (500 cm 3 of fluids), and the use of laxatives to minimize pelvic organ filling and motion of the prostate [4,27,29]. Direct visualization before treatment with ultrasound or pretreatment session computed tomography (CT) scans has been evaluated [17].…”

Laparoscopic Seminal Vesicle and Pelvic Lymph Node Resection before High-Dose Three-Dimensional Conformal Radiation Therapy for Localized Prostate Cancer

“…Planning system software using DVHs makes the dosimetric study more efficient and more precise according to the radiation dose delivered to the target volume as well as the surrounding critical organs. IMRT [3] or the use of an intrarectal balloon [11] during the radiation course can also contribute to a decrease in the dose delivered to the rectum.…”

Postoperative Radiotherapy for Prostate Cancer

“…Furthermore, RT is applied as salvage therapy for an isolated rise in prostate-specific antigen after radical prostatectomy [16]. The postoperative prescription dose is usually lower (< 70 Gy) [17] compared to the primary treatment (≥ 70 Gy) [5][6][7]14].…”