Analysis of fiducial marker-based position verification in the external beam radiotherapy of patients with prostate cancer

Heide, Uulke A. van der; Kotte, A.N.T.J.; Dehnad, Homan; Hofman, P.; Lagenijk, Jan J.W.; Vulpen, Marco van

doi:10.1016/j.radonc.2006.11.002

Cited by 138 publications

(92 citation statements)

References 29 publications

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“…Prostate volume decreases during oncology treatment are well documented (9,10). This phenomenon causes a decrease in intermarker distance and could be distinguished by marker migration (11). Contemporary treatment algorithm expects unchanging prostate volume and shape.…”

Section: Discussionmentioning

confidence: 99%

Daily Prostate Volume and Position Monitoring Using Implanted Gold Markers and On-Board Imaging during Radiotherapy

Kašaová

Sirák

Jansa

et al. 2011

Acta Med. (Hradec Kralove, Czech Repub.)

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2Summary: Purpose: This study aimed to evaluate prostate volume changes and prostate motions during radiotherapy.Methods: In 2010, twenty-five patients were treated for prostate cancer by external beam radiotherapy with implanted fiducial markers. Coordinates of three gold markers on kilovoltage images were calculated daily. Volume changes in target structure were observed through changes in intermarker distances. Differences in patient position between laser-tattoo alignment and gold marker localization were evaluated. Intrafraction motion was assessed by measuring marker displacement on kilovoltage images acquired before and after fraction delivery. Results: Prostate shrinkage was observed in 60% of patients. The average shrinkage was 7% of the prostate's initial volume. Corrections after laser-tattoo alignment remained mostly below 1 cm. The difference between marker centroid position on the actual images and the planning images was 2 ± 1 mm on average. The extension of intrafraction movements was 7.6 ± 0.2 mm on average. Conclusions: In our retrospective study, the possibility for prostate volume changes during radiotherapy was revealed. Intrafraction movements turned out to be the limiting factor in safety margin reduction.

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Section: Discussionmentioning

confidence: 99%

Daily Prostate Volume and Position Monitoring Using Implanted Gold Markers and On-Board Imaging during Radiotherapy

Kašaová

Sirák

Jansa

et al. 2011

Acta Med. (Hradec Kralove, Czech Repub.)

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“…All patients in the IMRT group received dose escalation to the prostate corpus, delineated on CT, of 76 Gy in 35 fractions of 2.17 Gy with a multileaf collimator and 10-MV photons (7). In this group transrectally implanted gold markers were used for daily position verification, which provides more accurate positioning of the prostate, resulting in more precise delivery of the radiation dose to the prostate and the organs at risk (7,8).…”

Section: Methodsmentioning

confidence: 99%

“…In this group transrectally implanted gold markers were used for daily position verification, which provides more accurate positioning of the prostate, resulting in more precise delivery of the radiation dose to the prostate and the organs at risk (7,8).…”

Section: Methodsmentioning

confidence: 99%

“…Raising the dose from 68 Gy to 78 Gy using conformal radiotherapy resulted in more late gastrointestinal and genitourinary toxicity ($5% Grade 3) (5). However, advances in technology like intensity-modulated radiotherapy (IMRT) (6) and improved position verification of the prostate (7,8) have enabled dose escalation while treatment-related complications are minimized. For evaluation of treatment, not only toxicity but also impact on QoL is increasingly important (9).…”

Section: Introductionmentioning

confidence: 99%

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Health-Related Quality of Life in Patients With Locally Advanced Prostate Cancer After 76 Gy Intensity-Modulated Radiotherapy vs. 70 Gy Conformal Radiotherapy in a Prospective and Longitudinal Study

Lips

Dehnad

Kruger

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose: To compare quality of life (QoL) after 70 Gy conformal radiotherapy with QoL after 76 Gy intensitymodulated radiotherapy (IMRT) in patients with locally advanced prostate carcinoma. Methods and Materials: Seventy-eight patients with locally advanced prostate cancer were treated with 70 Gy three-field conformal radiotherapy, and 92 patients received 76 Gy IMRT with fiducial markers for position verification. Quality of life was measured by RAND-36, the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30(+3)), and the prostate-specific EORTC QLQ-PR25, before radiotherapy (baseline) and 1 month and 6 months after treatment. Quality of life changes in time (baseline vs. 1 month and baseline vs. 6 months) of $10 points were considered clinically relevant. Results: Differences between the treatment groups for QoL changes over time occurred in several QoL domains. The 76-Gy group revealed no significant deterioration in QoL compared with the 70-Gy group. The IMRT 76-Gy group even demonstrated a significantly better change in QoL from baseline to 1 month in several domains. The conformal 70-Gy group revealed temporary deterioration in pain, role functioning, and urinary symptoms; for the IMRT 76-Gy group a better QoL in terms of change in health existed after 1 month, which persisted after 6 months. For both treatment groups temporary deterioration in physical role restriction occurred after 1 month, and an improvement in emotional role restriction occurred after 6 months. Sexual activity was reduced after treatment for both groups and remained decreased after 6 months. Conclusions: Intensity-modulated radiotherapy and accurate position verification seem to provide a possibility to increase the radiation dose for prostate cancer without deterioration in QoL. Ó 2007 Elsevier Inc.

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“…Fiducial markers are frequently implanted in the prostate to verify its location during image guidance, both to eliminate uncertainties regarding position resulting from prostate motion and to avoid patient setup errors [14,15]. The implanted fiducial markers predominantly in use today are gold seeds.…”

Section: Image Guidancementioning

confidence: 99%

Technological Advances in Radiation Therapy for Prostate Cancer

Choi

Hung

2010

Curr Urol Rep

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Radiation therapy (RT) for prostate cancer has made huge strides over the past two decades. The addition of image guidance has allowed radiation oncologists to ensure accurate delivery of increasingly precise radiation treatment plans using newer conformal therapy methods such as three-dimensional conformal RT, intensitymodulated RT, and proton beam RT. Regardless of the specific treatment technique, patients can depend on the treatment to target the moving prostate effectively while significantly sparing adjacent tissues, thereby reducing the morbidity of having to undergo prostate cancer therapy. This review summarizes the recent technical advances made in radiation dose delivery, including target volume definition, treatment planning, treatment delivery methods, and positional verification methods during RT.

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Analysis of fiducial marker-based position verification in the external beam radiotherapy of patients with prostate cancer

Cited by 138 publications

References 29 publications

Daily Prostate Volume and Position Monitoring Using Implanted Gold Markers and On-Board Imaging during Radiotherapy

Daily Prostate Volume and Position Monitoring Using Implanted Gold Markers and On-Board Imaging during Radiotherapy

Health-Related Quality of Life in Patients With Locally Advanced Prostate Cancer After 76 Gy Intensity-Modulated Radiotherapy vs. 70 Gy Conformal Radiotherapy in a Prospective and Longitudinal Study

Technological Advances in Radiation Therapy for Prostate Cancer

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