Pelvic nodal dosing with registration to the prostate: implications for high-risk prostate cancer patients receiving stereotactic body radiation therapy

International Journal of Radiation Oncology, Biology, Physics
Amar U KishanChristopher R King

Abstract

To determine whether image guidance with rigid registration (RR) to intraprostatic markers (IPMs) yields acceptable coverage of the pelvic lymph nodes in the context of a stereotactic body radiation therapy (SBRT) regimen. Four to seven kilovoltage cone-beam CTs (CBCTs) from 12 patients with high-risk prostate cancer were analyzed, allowing approximation of an SBRT regimen. The nodal clinical target volume (CTV(N)) and bladder were contoured on all kilovoltage CBCTs. The V100 CTV(N), expressed as a ratio to the same parameter on the initial plan, and the magnitude of translational shift between RR to the IPMs versus RR to the pelvic bones, were computed. The ability of a multimodality bladder filling protocol to minimize bladder height variation was assessed in a separate cohort of 4 patients. Sixty-five CBCTs were assessed. The average V100 CTV(N) was 92.6%, but for a subset of 3 patients the average was 80.0%, compared with 97.8% for the others (P<.0001). The average overall and superior-inferior axis magnitudes of the bony-to-fiducial translations were significantly larger in the subgroup with suboptimal nodal coverage (8.1 vs 3.9 mm and 5.8 vs 2.4 mm, respectively; P<.0001). Relative bladder height changes were also signifi...Continue Reading

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Citations

Nov 20, 2015·International Journal of Radiation Oncology, Biology, Physics·Amar U KishanChristopher R King
Jun 18, 2019·Journal of Applied Clinical Medical Physics·Neelam TyagiMichael Zelefsky
Jan 1, 2019·Journal of Radiation Oncology·Ulrika BjörelandCamilla Thellenberg-Karlsson
Dec 29, 2020·Frontiers in Oncology·Boris R ToccoAlison C Tree

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