Determination of the CTV-PTV margin for prostate cancer radiotherapy depending on the prostate gland positioning control method

• Autorzy: Sobajtis, Aleksandra , Kukołowicz, Paweł
• Języki publikacji: EN

Abstrakty

EN

Objective: The objective of the study was to determine the correct CTV-PTV margin, depending on the method used to verify the PG position. In the study, 3 methods of CBCT image superimposition were assessed as based on the location of the prostate gland (CBCT images), a single gold marker, and pubic symphysis respectively. Materials and methods: The study group consisted of 30 patients undergoing irradiation therapy at the University Hospital in Zielona Góra. The therapy was delivered using the VMAT (Volumetric Modulated Arc Therapy) protocol. CBCT image-based superimposition (prostate-based alignment) was chosen as the reference method. The uncertainty of the PG positioning method was determined and the margin to be used was determined for the CBCT-based reference method. Then, changes in the position of the prostate gland relative to these determined using the single marker and pubic symphysis-based methods were determined. The CTV-PTV margin was calculated at the root of the sum of the squares for the doubled value of method uncertainty for the CBCT image-based alignment method and the value of the difference between the locations of planned and actual isocenters as determined using the method of interest and the CBCT-based alignment method for which the total number of differences accounted for 95% of all differences. Results: The CTV-PTV margins to be used when the prostate gland is positioned using the CBCT imaging, single marker, and pubic symphysis-based methods were determined. For the CBCT-based method, the following values were obtained for the Vrt, Lng, and Lat directions respectively: 0.43 cm, 0.48 cm, 0.29 cm. For the single marker-based method, the respective values were 0.7 cm, 0.88 cm, and 0.44 cm whereas for the pubic symphysis-based method these were 0.65 cm, 0.76 cm, and 0.46 cm. Conclusions: Regardless of the method, the smallest margin values were obtained for the lateral direction, with the CBCT-based method facilitating the smallest margins to be used. The largest margins were obtained using the single marker-based alignment method.

Słowa kluczowe

EN

prostate; CTV-PTV margin; marker; positioning control

• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2020
• Tom: Vol. 26, Iss. 4
• Strony: 169--179
• Opis fizyczny: Bibliogr. 29 poz., rys., tab.

Twórcy

autor

Sobajtis, Aleksandra

• Medical Physics Department, University Hospital, Zyty 26, Zielona Góra, Poland,

autor

Kukołowicz, Paweł

• Medical Physics Department, Center of Oncology, W. K. Roentgena 5, Warsaw, Poland

Bibliografia

• 1. Cuzick J, Thorat M, Andriole G, et al. Prevention and Early Detection of Prostate Cancer. Lancet Oncol. 2014 Oct; 15(11): e484–e492. doi: 10.1016/S1470-2045(14)70211-6
• 2. Khullar K, Parikh R. The role of radiotherapy in metastatic prostate cancer. Am J Clin Exp Urol. 2019; 7(2): 92–97.
• 3. Byrne T. A Review of Prostate Motion With Considerations for the Treatment of Prostate Cancer. Med Dosim. Fall 2005; 30(3):155-61. doi: 10.1016/j.meddos.2005.03.005.
• 4. Gawlik – Jakubczak T, Matuszewski M. Fiducial markers in the treatmentof prostate cancer: technique and short term observation. Oncology in Clinical Practice. 2015; Vol. 11, No. 6, 295–299.
• 5. Piotrowski T. Wybrane zagadnienia dotyczące planowania leczenia w radioterapii. Wielkopolskie Centrum Onkologii.
• 6. Chen Z, Yang Z, Wang J, Hu W. Dosimetric impact of different bladder and rectum filling during prostate cancer. Radiation Oncology. 2016, Vol 11, Article number: 103.
• 7. Yartsev S, Bauman G. Target margins in radiotherapy of prostate cancer. Br J Radiol. November 2016; 89(1067): 20160312. doi: 10.1259/bjr.20160312.
• 8. Bodusz D, Głowacki G, Miszczyk L. Ocena śródfrakcyjnej ruchomości gruczołu krokowego w trakcie radioterapii chorych na raka stercza. Nowotwory. Journal of Oncology. 2011; 61(5):439.
• 9. Antico M, et al. Real-time adaptive planning method for radiotherapy treatment delivery for prostate cancer patients, based on a library of plans accounting for possible anatomy configuration changes. PLoS One. 2019; 14(2): e0213002. doi: 10.1371/journal.pone.0213002.
• 10. Oborska D. Obrazowanie w radioterapii - kryteria jakości obrazów MV vs kV, planarne vs wolumetryczne. II Konferencja z zakresu detekcji promieniowania jonizującego oraz kontroli jakości w rentgenodiagnostyce, radioterapii i medycynie nuklearnej, Klimówka, Poland, Maj 2015.
• 11. Merriel S, Funston G, Hamilton W. Prostate Cancer in Primary Care. Adv Ther. 2018; 35(9): 1285–1294. doi: 10.1007/s12325-018-0766-1.
• 12. Rawla P. Epidemiology of Prostate Cancer. World J Oncol. 2019 Apr; 10(2): 63–89. doi: 10.14740/wjon1191.
• 13. Chen F, Zhao X. Prostate Cancer: Current Treatment and Prevention Strategies. Iran Red Crescent Med J. 2013 Apr; 15(4): 279–284. doi: 10.5812/ircmj.6499.
• 14. Koukourakis G, Kelekis N, Armonis V, Kouloulias V. Brachytherapy for Prostate Cancer: A Systematic Review. Adv Urol. 2009; 2009: 327945. doi: 10.1155/2009/327945.
• 15. Lam Cham Kee D, Peiffert D, J-M Hannoun-Lévi. Brachytherapy Boost for Prostate Cancer: A National Survey From Groupe curiethérapie - Société française De radiothérapie Oncologique. Cancer Radiother. 2019 Dec;23(8):847-852. doi: 10.1016/j.canrad.2019.06.003.
• 16. Posiewnik M, Piotrowski T. A review of cone-beam CT applications for adaptive radiotherapy of prostate cancer. European Journal of Medical Physics. Vol 59, p 13-21, March 2019.
• 17. Yaver M, Foo A, Larsen T, et. al. Consistency of Organ Geometries During Prostate Radiotherapy With Two Different Bladder and Bowel Regimens. J Med Imaging Radiat Sci. 2015 Dec;46(4):380-387. doi: 10.1016/j.jmir.2015.09.001.
• 18. Ren W, Sun Ch, Lu N, et. al, Dosimetric Comparison of Intensity-Modulated Radiotherapy and Volumetric-Modulated Arc Radiotherapy in Patients With Prostate Cancer: A Meta-Analysis. J Appl Clin Med Phys. 2016 Nov 8;17(6):254-262. doi: 10.1120/jacmp.v17i6.6464.
• 19. McNair H, Hansen V, Parker Ch, et. al. A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy. Int J Radiat Oncol Biol Phys. 2008 May 1;71(1):41-50. doi: 10.1016/j.ijrobp.2007.09.002.
• 20. O’Neill A, Jain S, Hounsell A, et. al. Fiducial marker guided prostate radiotherapy: a review. Br J Radiol. December 2016; 89(1068): 20160296. doi: 10.1259/bjr.20160296.
• 21. Pérez-Romasanta L, Lozano-Martín E, Velasco-Jiménez J, et. al. CTV to PTV Margins for Prostate Irradiation. Three-dimensional Quantitative Assessment of Interfraction Uncertainties Using Portal Imaging and Serial CT Scans. Clin Transl Oncol. 2009 Sep;11(9):615-21.doi: 10.1007/s12094-009-0413-z.
• 22. Kukołowicz P, Kukołowicz H, Tyburska I. Dependence of the Safe Rectum Dose on the CTV-PTV Margin Size and Treatment Technique. Rep Pract Oncol Radiother. May-Jun 2015;20(3):198-203. doi: 10.1016/j.rpor.2014.12.004.
• 23. Ziółkowski S, Biedka M, Żmuda E, Ziółkowska E. Trudności w przeprowadzeniu radioterapii u chorych z otyłością. Inżynier i Fizyk Medyczny. 2014, Vol. 3, p 111-116.
• 24. Lin L, Hertan L, Rengan R, et. al. Effect of Body Mass Index on Magnitude of Setup Errors in Patients Treated With Adjuvant Radiotherapy for Endometrial Cancer With Daily Image Guidance. Int J Radiat Oncol Biol Phys. 2012 Jun 1;83(2):670-5.doi: 10.1016/j.ijrobp.2011.07.026.
• 25. Bentzen S, Constine L, Deasy J, et. al. Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): An Introduction to the Scientific Issues. Int J Radiat Oncol Biol Phys. 2010 Mar 1; 76(3 Suppl): S3–S9. doi: 10.1016/j.ijrobp.2009.09.040.
• 26. NCNN (National Comrehensive Cancer Network) Guidelines Version 2.2017.
• 27. NCNN (National Comrehensive Cancer Network) Guidelines Version 1.2020.
• 28. Piziorska M, Kukołowicz P, Zawadzka A, et. al. Adaptive off-line protocol for prostate external radiotherapy with cone beam computer tomography. Strahlentherapie und Onkologie. 2012. Vol. 188, p 1003–1009.
• 29. McKenzie A, Herk M, Mijnheer B. Margins for Geometric Uncertainty Around Organs at Risk in Radiotherapy. Radiother Oncol. 2002 Mar;62(3):299-307. doi: 10.1016/s0167-8140(02)00015-4.

Uwagi

Opracowanie rekordu ze środków MNiSW, umowa Nr 461252 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2021).

Identyfikatory

DOI

10.2478/pjmpe-2020-0020