Dose/volume-response relations for rectal morbidity using planned and simulated motion-inclusive dose distributions Journal Article
| Authors: | Thor, M.; Apte, A.; Deasy, J. O.; Karlsdóttir, À; Moiseenko, V.; Liu, M.; Muren, L. P. |
| Article Title: | Dose/volume-response relations for rectal morbidity using planned and simulated motion-inclusive dose distributions |
| Abstract: | Background and purpose Many dose-limiting normal tissues in radiotherapy (RT) display considerable internal motion between fractions over a course of treatment, potentially reducing the appropriateness of using planned dose distributions to predict morbidity. Accounting explicitly for rectal motion could improve the predictive power of modelling rectal morbidity. To test this, we simulated the effect of motion in two cohorts. Materials and methods The included patients (232 and 159 cases) received RT for prostate cancer to 70 and 74 Gy. Motion-inclusive dose distributions were introduced as simulations of random or systematic motion to the planned dose distributions. Six rectal morbidity endpoints were analysed. A probit model using the QUANTEC recommended parameters was also applied to the cohorts. Results The differences in associations using the planned over the motion-inclusive dose distributions were modest. Statistically significant associations were obtained with four of the endpoints, mainly at high doses (55-70 Gy), using both the planned and the motion-inclusive dose distributions, primarily when simulating random motion. The strongest associations were observed for GI toxicity and rectal bleeding (Rs = 0.12-0.21; Rs = 0.11-0.20). Applying the probit model, significant associations were found for tenesmus and rectal bleeding (Rs = 0.13, p = 0.02). Conclusion Equally strong associations with rectal morbidity were observed at high doses (>55 Gy), for the planned and the simulated dose distributions including in particular random rectal motion. Future studies should explore patient-specific descriptions of rectal motion to achieve improved predictive power. © 2013 Elsevier Ireland Ltd. All rights reserved. |
| Keywords: | radiotherapy; morbidity; prostate cancer; rectum; organ motion |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 109 |
| Issue: | 3 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-12-01 |
| Start Page: | 388 |
| End Page: | 393 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2013.10.021 |
| PROVIDER: | scopus |
| PUBMED: | 24231236 |
| PMCID: | PMC4765373 |
| DOI/URL: | |
| Notes: | Cited By (since 1996):1 -- Export Date: 2 January 2014 -- CODEN: RAOND -- Source: Scopus |
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