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

   


Authors: Munck Af Rosenschöld, P.; Desai, N. B.; Oh, J. H.; Apte, A.; Hunt, M.; Kalikstein, A.; Mechalakos, J.; Happersett, L.; Deasy, J. O.; Zelefsky, M. J.
Article Title: Modeling positioning uncertainties of prostate cancer external beam radiation therapy using pre-treatment data
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 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. © 2014 Elsevier Ireland Ltd. All rights reserved.
Keywords: prostate cancer; igrt; image guided radiotherapy; interfraction motion
Journal Title: Radiotherapy and Oncology
Volume: 110
Issue: 2
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2014-02-01
Start Page: 251
End Page: 255
Language: English
DOI: 10.1016/j.radonc.2013.12.010
PROVIDER: scopus
PUBMED: 24560753
PMCID: PMC4822486
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-84896395902&partnerID=40&md5=aa814234640e51b6daace57fd366fe44
Notes: Export Date: 2 April 2014 -- CODEN: RAOND -- Source: Scopus
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MSK Authors
  1. Michael J Zelefsky
    754 Zelefsky
  2. Laura Happersett
    89 Happersett
  3. Neil B Desai
    36 Desai
  4. James G Mechalakos
    164 Mechalakos
  5. Jung Hun Oh
    187 Oh
  6. Joseph Owen Deasy
    524 Deasy
  7. Margie A Hunt
    287 Hunt
  8. Aditya Apte
    203 Apte
  9. Per Martin Munck Af Rosenschold
    6 Munck Af Rosenschold
  10. Abraham Kalikstein
    3 Kalikstein
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