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Radiation Oncology
Published in: Radiation Oncology 1/2017

Open Access 01-12-2017 | Research

A novel CBCT-based method for derivation of CTV-PTV margins for prostate and pelvic lymph nodes treated with stereotactic ablative radiotherapy

Authors: Ciara A. Lyons, Raymond B. King, Sarah O.S. Osman, Stephen J. McMahon, Joe M. O’Sullivan, Alan R. Hounsell, Suneil Jain, Conor K. McGarry

Published in: Radiation Oncology | Issue 1/2017

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Abstract

Background

Traditional CTV-PTV margin recipes are not generally applicable in the situation of stereotactic ablative radiotherapy (SABR) treatments of multiple target volumes with a single isocentre. In this work, we present a novel geometric method of margin derivation based on CBCT-derived anatomical data.

Methods

Twenty patients with high-risk localized prostate cancer were selected for retrospective review. Individual volumes of interest (prostate, prostate and seminal vesicles and pelvic lymph nodes) were delineated on five representative CBCTs and registered to the planning CT using two registration protocols: bone match or prostate-based soft tissue match. Margins were incrementally expanded around composite CTV structures until 95% overlap was achieved.

Results

CTV-PTV margins of 5.2, 6.5 and 7.6 mm were required for prostate, prostate and seminal vesicles and pelvic lymph nodes respectively using a prostate matching protocol. For the prostate and seminal vesicle structures, margins calculated using our method displayed good agreement with a conventional margin recipe (within ±1.0 mm).

Conclusions

We have presented an alternative method of CTV-PTV margin derivation that is applicable to SABR treatments with more than one isocentric target. These results have informed an institutional trial of prostate and pelvic nodal SABR in men with high-risk localized prostate cancer.
Appendix
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Metadata
Title
A novel CBCT-based method for derivation of CTV-PTV margins for prostate and pelvic lymph nodes treated with stereotactic ablative radiotherapy
Authors
Ciara A. Lyons
Raymond B. King
Sarah O.S. Osman
Stephen J. McMahon
Joe M. O’Sullivan
Alan R. Hounsell
Suneil Jain
Conor K. McGarry
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-017-0859-z

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