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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 1/2017

01-01-2017 | Original Article

Prostate bed target interfractional motion using RTOG consensus definitions and daily CT on rails

Does target motion differ between superior and inferior portions of the clinical target volume?

Authors: Vivek Verma, MD, Shifeng Chen, PhD, Sumin Zhou, PhD, Charles A. Enke, MD, Andrew O. Wahl, MD

Published in: Strahlentherapie und Onkologie | Issue 1/2017

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Abstract

Purpose

Using high-quality CT-on-rails imaging, the daily motion of the prostate bed clinical target volume (PB-CTV) based on consensus Radiation Therapy Oncology Group (RTOG) definitions (instead of surgical clips/fiducials) was studied. It was assessed whether PB motion in the superior portion of PB-CTV (SUP-CTV) differed from the inferior PB-CTV (INF-CTV).

Patients and methods

Eight pT2-3bN0-1M0 patients underwent postprostatectomy intensity-modulated radiotherapy, totaling 300 fractions. INF-CTV and SUP-CTV were defined as PB-CTV located inferior and superior to the superior border of the pubic symphysis, respectively. Daily pretreatment CT-on-rails images were compared to the planning CT in the left–right (LR), superoinferior (SI), and anteroposterior (AP) directions. Two parameters were defined: “total PB-CTV motion” represented total shifts from skin tattoos to RTOG-defined anatomic areas; “PB-CTV target motion” (performed for both SUP-CTV and INF-CTV) represented shifts from bone to RTOG-defined anatomic areas (i. e., subtracting shifts from skin tattoos to bone).

Results

Mean (± standard deviation, SD) total PB-CTV motion was −1.5 (± 6.0), 1.3 (± 4.5), and 3.7 (± 5.7) mm in LR, SI, and AP directions, respectively. Mean (± SD) PB-CTV target motion was 0.2 (±1.4), 0.3 (±2.4), and 0 (±3.1) mm in the LR, SI, and AP directions, respectively. Mean (± SD) INF-CTV target motion was 0.1 (± 2.8), 0.5 (± 2.2), and 0.2 (± 2.5) mm, and SUP-CTV target motion was 0.3 (± 1.8), 0.5 (± 2.3), and 0 (± 5.0) mm in LR, SI, and AP directions, respectively. No statistically significant differences between INF-CTV and SUP-CTV motion were present in any direction.

Conclusion

There are no statistically apparent motion differences between SUP-CTV and INF-CTV. Current uniform planning target volume (PTV) margins are adequate to cover both portions of the CTV.
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Metadata
Title
Prostate bed target interfractional motion using RTOG consensus definitions and daily CT on rails
Does target motion differ between superior and inferior portions of the clinical target volume?
Authors
Vivek Verma, MD
Shifeng Chen, PhD
Sumin Zhou, PhD
Charles A. Enke, MD
Andrew O. Wahl, MD
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 1/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-016-1077-6

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