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Changes in Volume Dose by Treatment Plan According to pCT and CBCT in Image-guided Radiation Therapy for Prostate Cancer

전립선암 영상유도방사선치료 시 pCT와 CBCT에 따른 치료계획별 체적선량의 변화

  • Won, Young Jin (Department of Radiation Oncology, InJe University Ilsan Paik Hospital) ;
  • Kim, Jung Hoon (Department of Radiation Oncology, KonYang University Hospital)
  • 원영진 (인제대학교 일산백병원 방사선종양학과) ;
  • 김정훈 (건양대학교병원 방사선종양학과)
  • Received : 2018.02.20
  • Accepted : 2018.05.18
  • Published : 2018.06.30

Abstract

The results of CBCT was obtained using image guided radiation therapy for radiation therapy in 5 prostate cancer patients. Using these results, we compared and evaluated the dose changes according to the treatment plan depending on the volume and position of bladder, rectum, and prostate. The 28 images of CBCT were acquired using On-Board Imaging device before radiotherapy. After the outline of bladder, rectum, and PTV, pCT images and CBCT images for radiotherapy were treated respectively. The volume of the bladder was increased by 105.6% and decreased by 45.2%. The volume of the rectum was increased by 30.5% and decreased by 20.3%. Prostate volume was increased by 6.3% and decreased by 12.3%. The mean dose of the rectum was higher in the CBCT than in the pCT, and V40 (equivalent to 40 Gy) of the bladder showed a reduction in all treatment regimens in the CBCT than in the pCT. Conformity treatment and homogeneity index of PTV showed better results in all treatment regimens using pCT than CBCT. It was found that the dose distribution of the pelvic internal organs varied greatly according to the patient 's condition and pretreatment.

Keywords

References

  1. Perez, C.A, Brady, L.W.: Priciples and practice of radiation oncology: Carcinoma of the prostate. 4th. edit. Lippincott Co. Phiadelphia, 2004.
  2. Kim SU, Kim MS, Yun SM.: Dose distribution of intensity modulated radiation therapy and 3 dimensional conformal radiation therapy in prostate cancer. Yeungnam University J of Med, Vol. 24, No. 2, pp. 538-543, 2007.
  3. Erjona B, Ervis T, Elvisa K.: Comparison of 3DCRT and IMRT treatment plans. Acta Inform Med, Vol. 21, No. 3, pp. 211-212, 2013. https://doi.org/10.5455/aim.2013.21.211-212
  4. The BS, Dong L, McGary JE, Mai WY, Grant W, Butler EB.: Rectal wall sparing by dosimetric effect of rectal balloon used during intensity-modulated radiation therapy (IMRT) for prostate cancer. Med Dosim, Vol. 30, No. 1, pp. 25-30, 2005. https://doi.org/10.1016/j.meddos.2004.10.005
  5. Wachter S, Gerstener N, Dorner D, Goldner G, Colotto A, Wambersie A, et al.: The ifluence of a rectal ballon tube as internal immobilization device on variations of volumes and dose-volume histograms during treatment course of conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys, Vol. 52, No. 1, pp. 91-100, 2002. https://doi.org/10.1016/S0360-3016(01)01821-1
  6. Court L, Rosen I, Mohan R, Dong L.: Evaluation of mechanical precision and alignment uncertainties for an integrated CT/LINAC system. Med Phys, Vol. 30, No. 6, pp. 1198-210, 2003. https://doi.org/10.1118/1.1573792
  7. Roach M. 3rd, Faillace-Akazawa P, Malfatti C.: Prostate volumes and organ movement defined by serial computerized tomographic scans during three-dimensional conformal radiotherapy. Radiation oncology investigations, Vol. 5, No. 4, pp. 187-194, 1997. https://doi.org/10.1002/(SICI)1520-6823(1997)5:4<187::AID-ROI4>3.0.CO;2-U
  8. Akino Y, Yoshioka Y, Fukuda S, Maruoka S, Takahashi Y, Yagi M, et al.: Estimation of rectal dose using daily megavoltage cone-beam computed tomography and deformable image registration. Int J Radiat Oncol Biol Phys, Vol. 87, No. 3, pp. 602-608, 2013. https://doi.org/10.1016/j.ijrobp.2013.06.2054
  9. Haworth A, Paneghel A, Herschtal A, Duchesne G, Willams S, Tai Kh, et al.: Verification of target posi- tion in the post-prostatectomy cancer patient using cone beam CT. J Med Imaging Radiat Oncol, Vol. 53, No. 2, pp. 212-220, 2009. https://doi.org/10.1111/j.1754-9485.2009.02057.x
  10. Nijkamp J, Pos FJ, Nuver TT, de Jong R, Remeijer P, Snoke JJ, et al.: Adaptive radiotherapy for prostate cancer using kilovoltage cone-beam computed tomography: first clinical results. Int J Radiat Oncol Biol Phys, Vol. 70, No. 1, pp. 75-82, 2008. https://doi.org/10.1016/j.ijrobp.2007.05.046
  11. LoLc Feuvret, NoLl G, Mazeron JJ, Bey P.: Conformity index:A review. Int J Radiat Oncol Biol Phys, Vol. 64, No. 2, pp. 333-342, 2006. https://doi.org/10.1016/j.ijrobp.2005.09.028
  12. Yoo S, Wu QJ, Lee WR, Yin FF.: Radiotherapy treatment plans with rapidarc for prostate cancer involving seminal vesicles and lymph nodes. Int J Radiat Oncol Biol Phys, Vol. 76, No. 3. pp. 935-942, 2010.
  13. Michalski JM, Winter K, Purdy JA, Parliament M, Wong H, Perez CA, et al.: Toxicity after three-dimensional radiotherapy for prostate cancer on RTOG 9406 dose level V. Int J Radiat Oncol Biol Phys, Vol. 62, No. 3, pp. 706-713, 2005. https://doi.org/10.1016/j.ijrobp.2004.11.028
  14. Kwon KT, Min JW.: Comparison of doses according to change of bladder volume in treatment of prostate cancer. J Radiol Sci Technol, Vol. 40, No. 3, pp. 415-421, 2017. https://doi.org/10.17946/JRST.2017.40.3.09
  15. Boda-Heggemann J, Lohr F, Wenz F, Flentje M, Guckenberger M.: kV Cone-Beam CT-Based IGRT. Strahlenther Onkol, Vol. 187, No. 5, pp. 284-291, 2011. https://doi.org/10.1007/s00066-011-2236-4
  16. Nutting C, Deamaley DP, Webb S.: Intensity modulated radiation therapy: a clinical review. British J Radiol, Vol. 73, No. 869, pp. 459-469, 2000. https://doi.org/10.1259/bjr.73.869.10884741
  17. Feuvret L, NoLl G, Mazeron JJ, Bey P.: Conformity index: a review. Int J Radiat Oncol Biol Phys, Vol 64, No. 2, pp 333-342, 2006. https://doi.org/10.1016/j.ijrobp.2005.09.028