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Modeling positioning uncertainties of prostate cancer external beam radiation therapy using pre-treatment data

Munck Af Rosenschöld, Per LU orcid ; Desai, Neil B. ; Oh, Jung Hun ; Apte, Aditya ; Hunt, Margie ; Kalikstein, Abraham ; Mechalakos, James ; Happersett, Laura ; Deasy, Joseph O. and Zelefsky, Michael J. (2014) In Radiotherapy and Oncology 110(2). p.251-255
Abstract

Purpose To investigate the influence of treatment plan data and image guidance (IG) on positioning uncertainty during prostate cancer (PCa) radiotherapy (RT). Methods Body mass index (BMI), planning target volume (PTV), bladder volume (BV), and rectal cross section area (RCS) were collected for 267 consecutive PCa patients undergoing daily IGRT. Radiographic isocenter corrections to intra-prostatic fiducials for 12,490 treatment fractions were used to derive random (RE) and systematic (SE) inter-fraction uncertainties for the cardinal axes. These data were used to simulate RE and SE for weekly IG and Action Level (AL)-IG treatment protocols. Results SE and RE were 2-5 and 3-4 mm in the cardinal axes, respectively, during simulation of... (More)

Purpose To investigate the influence of treatment plan data and image guidance (IG) on positioning uncertainty during prostate cancer (PCa) radiotherapy (RT). Methods Body mass index (BMI), planning target volume (PTV), bladder volume (BV), and rectal cross section area (RCS) were collected for 267 consecutive PCa patients undergoing daily IGRT. Radiographic isocenter corrections to intra-prostatic fiducials for 12,490 treatment fractions were used to derive random (RE) and systematic (SE) inter-fraction uncertainties for the cardinal axes. These data were used to simulate RE and SE for weekly IG and Action Level (AL)-IG treatment protocols. Results SE and RE were 2-5 and 3-4 mm in the cardinal axes, respectively, during simulation of no IG. Without IG, positive correlations (p < 0.01) were noted for (1) anterior-posterior RE vs. RCS and BV and (2) cranio-caudal RE vs. RCS, BV and BMI. The RE increase was 3 mm for the highest quartile of RCS, BV and BMI. Daily IGRT eliminated this relationship. 3D IG corrections of 1 cm or more occured in 27% of treatment fractions and in 97% of patients. Conclusion PCa patients with elevated pre-treatment BV, RCS and BMI have increased inter-fractionation positioning uncertainty and appear the primary candidates for daily IGRT.

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author
; ; ; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
IGRT, Image guided radiotherapy, Interfraction motion, Prostate cancer
in
Radiotherapy and Oncology
volume
110
issue
2
pages
251 - 255
publisher
Elsevier
external identifiers
  • pmid:24560753
  • scopus:84896395902
ISSN
0167-8140
DOI
10.1016/j.radonc.2013.12.010
language
English
LU publication?
no
id
01d3f640-922c-4161-bf97-889a12d1d00a
date added to LUP
2023-07-19 09:39:30
date last changed
2024-01-05 03:25:53
@article{01d3f640-922c-4161-bf97-889a12d1d00a,
  abstract     = {{<p>Purpose To investigate the influence of treatment plan data and image guidance (IG) on positioning uncertainty during prostate cancer (PCa) radiotherapy (RT). Methods Body mass index (BMI), planning target volume (PTV), bladder volume (BV), and rectal cross section area (RCS) were collected for 267 consecutive PCa patients undergoing daily IGRT. Radiographic isocenter corrections to intra-prostatic fiducials for 12,490 treatment fractions were used to derive random (RE) and systematic (SE) inter-fraction uncertainties for the cardinal axes. These data were used to simulate RE and SE for weekly IG and Action Level (AL)-IG treatment protocols. Results SE and RE were 2-5 and 3-4 mm in the cardinal axes, respectively, during simulation of no IG. Without IG, positive correlations (p &lt; 0.01) were noted for (1) anterior-posterior RE vs. RCS and BV and (2) cranio-caudal RE vs. RCS, BV and BMI. The RE increase was 3 mm for the highest quartile of RCS, BV and BMI. Daily IGRT eliminated this relationship. 3D IG corrections of 1 cm or more occured in 27% of treatment fractions and in 97% of patients. Conclusion PCa patients with elevated pre-treatment BV, RCS and BMI have increased inter-fractionation positioning uncertainty and appear the primary candidates for daily IGRT.</p>}},
  author       = {{Munck Af Rosenschöld, Per and Desai, Neil B. and Oh, Jung Hun and Apte, Aditya and Hunt, Margie and Kalikstein, Abraham and Mechalakos, James and Happersett, Laura and Deasy, Joseph O. and Zelefsky, Michael J.}},
  issn         = {{0167-8140}},
  keywords     = {{IGRT; Image guided radiotherapy; Interfraction motion; Prostate cancer}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{251--255}},
  publisher    = {{Elsevier}},
  series       = {{Radiotherapy and Oncology}},
  title        = {{Modeling positioning uncertainties of prostate cancer external beam radiation therapy using pre-treatment data}},
  url          = {{http://dx.doi.org/10.1016/j.radonc.2013.12.010}},
  doi          = {{10.1016/j.radonc.2013.12.010}},
  volume       = {{110}},
  year         = {{2014}},
}