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Strahlentherapie und Onkologie

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17.10.2018 | Original Article

Dosimetric and volumetric effects in clinical target volume and organs at risk during postprostatectomy radiotherapy

verfasst von: Ahmed Gawish, Ahmed Ali Chughtai, Prof.Dr.med. Michael J Eble

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 5/2019

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Abstract

Purpose

To assess the reproducibility of the dose–volume distribution of the initial simulation CT, generated using volumetric modulated arc therapy (VMAT) planning, during the radiotherapy of the prostatic bed based on weekly cone beam CTs (CBCT).

Methods

Twenty-three patients, after radical prostatectomy were treated with adjuvant or salvage radiotherapy between July and December 2016 and considered for this evaluation. Weekly CBCT scans (n = 138) were imported into the treatment planning system, and the clinical tumor volume (CTV), the rectum and the bladder were contoured. The initially calculated dose distribution and the dose–volume histograms generated from weekly CBCTs were compared. The prostatic fossa dose coverage was assessed by the proportion of the CTV fully encompassed by the 95% and 98% isodose lines. Rectal and bladder volumes receiving 50, 60 and 65 Gy during the treatment were compared to the initial plan, with statistical significance determined using the one-sample t‑test.

Results

Marked variations in the total organ volume of the rectum and the bladder were observed. The correlation between rectum volume and V₅₀ was not significant (p = 0.487), while the bladder volume and V₅₀ demonstrated a significant correlation. There was no correlation between urinary bladder volume and CTV. The change in rectal volume correlated significantly with CTV. The dose coverage (D_98% and D_95%) to the prostatic bed could be achieved for all patients due to the ventral shift in the volume differences of the rectum.

Conclusion

Weekly CBCTs can be considered as adequate verification tools to assess the interfractional variability of the CTV and organs at risk. The proven volume changes in the urinary bladder and the rectum do not compromise the final delivered dose in the CTV.

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Titel: Dosimetric and volumetric effects in clinical target volume and organs at risk during postprostatectomy radiotherapy
verfasst von: Ahmed Gawish
Ahmed Ali Chughtai
Prof.Dr.med. Michael J Eble
Publikationsdatum: 17.10.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 5/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1381-4

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Dosimetric and volumetric effects in clinical target volume and organs at risk during postprostatectomy radiotherapy

Abstract

Purpose

Methods

Results

Conclusion

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