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Strahlentherapie und Onkologie

Erschienen in:

12.10.2018 | Original Article

Penile bulb sparing in prostate cancer radiotherapy

Dose analysis of an in-house MRI system to improve contouring

verfasst von: F. Böckelmann, M. Hammon, S. Lettmaier, R. Fietkau, Prof. Dr. C. Bert, F. Putz

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 2/2019

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Abstract

Objective

This study aimed to assess the reduction in dose to the penile bulb (PB) achieved by MRI-based contouring following drinking and endorectal balloon (ERB) instructions.

Patients and methods

A total of 17 prostate cancer patients were treated with intensity-modulated radiation therapy (IMRT) and interstitial brachytherapy (IBT). CT and MRI datasets were acquired back-to-back based on a 65 cm³ air-filled ERB and drinking instructions. After rigid co-registration of the imaging data, the CT-based planning target volume (PTV) used for treatment planning was retrospectively compared to an MRI-based adaptive PTV and the dose to the PB was determined in each case. The adapted PTV encompassed a caudally cropped CT-based PTV which was defined on the basis of the MRI-based prostate contour plus an additional 5 mm safety margin.

Results

In the seven-field IMRT treatment plans, the MRI-based adapted PTV achieved mean (D_mean) and maximum (D_max) doses to the PB which were significantly lower (by 7.6 Gy and 10.9 Gy, respectively; p <0.05) than those of the CT-contoured PTV. For 6 patients, the estimated PB D_max (seven-field IMRT and IBT) for the adapted PTV was <70 Gy, whereas only 1 patient fulfilled this criterium with the CT-based PTV.

Conclusion

MRI-based contouring and seven-field IMRT-based treatment planning achieved dose sparing to the PB. Whereas the comparison of MRI and CT contouring only relates to external beam radiotherapy (EBRT) sparing, considering EBRT and IBT shows the improvement in PB sparing for the total treatment.

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Titel: Penile bulb sparing in prostate cancer radiotherapy
Dose analysis of an in-house MRI system to improve contouring
verfasst von: F. Böckelmann
M. Hammon
S. Lettmaier
R. Fietkau
Prof. Dr. C. Bert
F. Putz
Publikationsdatum: 12.10.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 2/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1377-0

Springer Medizin

Penile bulb sparing in prostate cancer radiotherapy

Dose analysis of an in-house MRI system to improve contouring

Abstract

Objective

Patients and methods

Results

Conclusion

Neu im Fachgebiet Onkologie

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

Alter verschlechtert Prognose bei Endometriumkarzinom

Darf man die Behandlung eines Neonazis ablehnen?

Update Onkologie

Springer Medizin

Abstract

Objective

Patients and methods

Results

Conclusion

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