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Strahlentherapie und Onkologie

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Open Access 01-02-2016 | Original Article

Image-guided intensity-modulated radiotherapy of prostate cancer

Analysis of interfractional errors and acute toxicity

Authors: Prof. Dr. med. Volker Rudat, A. Nour, M. Hammoud, A. Alaradi, A. Mohammed

Published in: Strahlentherapie und Onkologie | Issue 2/2016

Abstract

Purpose

The aim of the study was to estimate interfractional deviations in patient and prostate position, the impact of the frequency of online verification on the treatment margins, and to assess acute radiation reactions of high-dose external beam image-guided intensity-modulated radiotherapy (IG-IMRT) of localized prostate cancer.

Patients and methods

IG-IMRT was performed by daily online verification of implanted fiducial prostate markers using a megavoltage electronic portal imaging device (EPID). A total of 1011 image-guided treatment fractions from 23 consecutive unselected prostate cancer patients were analyzed. The median total dose was 79.2 Gy (range 77.4–81.0 Gy). Acute radiation reactions were assessed weekly during radiotherapy using the Common Terminology Criteria for Adverse Events (CTCAE) v.4.03.

Results

A relevant combined patient set-up and prostate motion population random error of 4–5 mm was observed. Compared to daily IGRT, image guidance every other day required an expansion of the CTV–PTV (clinical target volume–planning target volume) margin of 8.1, 6.6, and 4.1 mm in the longitudinal, vertical, and lateral directions, thereby, increasing the PTV by approximately 30–40 %. No grade 3 or 4 acute radiation reactions were observed with daily IG-IMRT.

Conclusion

A high dose with surprisingly low acute toxicity can be applied with daily IG-IMRT using implanted fiducial prostate markers. Daily image guidance is clearly superior to image guidance every other fraction concerning adequate target coverage with minimal margins.

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Title: Image-guided intensity-modulated radiotherapy of prostate cancer
Analysis of interfractional errors and acute toxicity
Authors: Prof. Dr. med. Volker Rudat
A. Nour
M. Hammoud
A. Alaradi
A. Mohammed
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 2/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0919-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Image-guided intensity-modulated radiotherapy of prostate cancer

Analysis of interfractional errors and acute toxicity

Abstract

Purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

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