Intensity-modulated radiation therapy (IMRT) for prostate cancer with the use of a rectal balloon for prostate immobilization: acute toxicity and dose–volume analysis

Teh, Bin S.; Yuan, Wei; Uhl, Barry M.; Augspurger, Mark E.; Grant, Walter H.; Lu, Haiquan; Woo, Shiao Y.; Carpenter, L. Steven; Chiu, J. Kam; Butler, E. Brian

doi:10.1016/s0360-3016(00)01428-0

Cited by 162 publications

(50 citation statements)

References 28 publications

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“…The acute effects observed for the patients treated herein were comparable for the most part to those reported by others (23,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), although there were some differences. We describe about a 48% rate of Grade 2 or higher maximum genitourinary reactions (Table 4), whereas the average in the other reports is 35% (range, 28-56%).…”

Section: Incidence Of Acute Toxicitysupporting

confidence: 86%

“…The drop in Grade 2 or higher acute genitourinary toxicity to <10% by 3 months after the completion of radiotherapy is noteworthy. In terms of Grade 2 or higher maximum gastrointestinal reactions, the average reported by others is about 30% (range, 14-52%) (23,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Our finding of about 13% (Table 6) is at the low end.…”

Section: Incidence Of Acute Toxicitycontrasting

confidence: 45%

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Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Pollack

Hanlon

Horwitz

et al. 2006

International Journal of Radiation Oncology*Biology*Physics

235

130

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Purpose-The α/β ratio for prostate cancer is postulated to be between 1 and 3, giving rise to the hypothesis that there may be a therapeutic advantage to hypofractionation. The dosimetry and acute toxicity are described in the first 100 men enrolled in a randomized trial.Patients and Methods-The trial compares 76 Gy in 38 fractions (Arm I) to 70.2 Gy in 26 fractions (Arm II) using intensity modulated radiotherapy. The planning target volume (PTV) margins in Arms I and II were 5 mm and 3 mm posteriorly and 8 mm and 7 mm in all other dimensions. The PTV D95% was at least the prescription dose.Results-The mean PTV doses for Arms I and II were 81.1 and 73.8 Gy. There were no differences in overall maximum acute gastrointestinal (GI) or genitourinary (GU) toxicity acutely. However, there was a slight but significant increase in Arm II GI toxicity during Weeks 2, 3, and 4. In multivariate analyses, only the combined rectal DVH parameter of V65 Gy/V50 Gy was significant for GI toxicity and the bladder volume for GU toxicity.Conclusion-Hypofractionation at 2.7 Gy per fraction to 70.2 Gy was well tolerated acutely using the planning conditions described.

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Section: Incidence Of Acute Toxicitysupporting

confidence: 86%

Section: Incidence Of Acute Toxicitycontrasting

confidence: 45%

Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Pollack

Hanlon

Horwitz

et al. 2006

International Journal of Radiation Oncology*Biology*Physics

235

130

View full text Add to dashboard Cite

show abstract

“…This approach to treating prostate cancer has been shown to achieve better tumor control 1 , 2 with less radiation damage to critical organs and a subsequent decrease in the incidence of toxic effects 3 , 6 . However, the high conformality, elevated dose, and small margins also make this approach more vulnerable to uncertainties that displace the target from the treatment field, such as interfractional and intrafractional organ movement and setup errors (7) …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a novel gas‐release endorectal balloon in the removal of rectal gas for prostate proton radiation therapy

Wootton

Kudchadker

Beddar

et al. 2012

J Applied Clin Med Phys

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Endorectal balloons (ERBs) are routinely used in prostate proton radiation therapy to immobilize the prostate and spare the rectal wall. Rectal gas can distend the rectum and displace the prostate even in the presence of ERBs. The purpose of this work was to quantify the effects an ERB with a passive gas release conduit had on the incidence of rectal gas. Fifteen patients who were treated with a standard ERB and 15 with a gas‐release ERB were selected for this retrospective study. Location and cross‐sectional area of gas pockets and the fraction of time they occurred on 1133 lateral kilovoltage (kV) images were analyzed. Gas locations were classified as trapped between the ERB and anterior rectal wall, between the ERB and posterior rectal wall, or superior to the ERB. For patients using the standard ERB, gas was found in at least one region in 45.8% of fractions. Gas was trapped in the anterior region in 37.1% of fractions, in the posterior region in 5.0% of fractions, and in the sigmoid region in 9.6% of fractions. For patients using the ERB with the gas‐release conduit, gas was found in at least one region in 19.7% of fractions. Gas was trapped in the anterior region in 5.6% of fractions, in the posterior region in 8.3% of fractions, and in the sigmoid region in 7.4% of fractions. Both the number of fractions with gas in the anterior region and the number of fractions with gas in at least one region were significantly higher in the former group than in the latter. The cross‐sectional area of trapped gas did not differ between the two groups. Thus gas‐release balloon can effectively release gas, and may be able to improve clinical workflow by reducing the need for catheterization.PACS number: 87.56.Da

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“…With this system, the current treatment‐planning margin is 12.5 mm in the S/I direction and 5 mm in the axial plane, which limits our mean prostate dose to

~ 77 Gy

. ( 20 , 21 ) This system is far from ideal toward developing further dose escalation.…”

Section: Introductionmentioning

confidence: 99%

Theoretical foundation for real‐time prostate localization using an inductively coupled transmitter and a superconducting quantum interference device (SQUID) magnetometer system

McGary

2004

J Applied Clin Med Phys

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Real‐time, 3D localization of the prostate for intensity‐modulated radiotherapy can be accomplished with passively charged radio frequency transmitters and superconducting quantum interference device (SQUID) magnetometers. The overall system design consists of an external dipole antenna as a power source for charging a microchip implant transmitter and SQUID magnetometers for signal detection. An external dipole antenna charges an on‐chip capacitor through inductive coupling in the near field region through a small implant inductor. The charge and discharge sequence between the external antenna and the implant circuit can be defined by half duplex, full duplex, or sequential operations. The resulting implant discharge current creates an alternating magnetic field through the inductor. The field is detected by the surrounding magnetometers, and the location of the implant transmitter can be calculated. Problems associated with this system design are interrelated with the signal strength at the detectors, detector sensitivity, and charge time of the implant capacitor. The physical parameters required for optimizing the system for real‐time applications are the operating frequency, implant inductance and capacitance, the external dipole current and loop radius, the detector distance, and mutual inductance. Consequently, the sequential operating mode is the best choice for real‐time localization for constraints requiring positioning within 1 s due to the mutual inductance and detector sensitivity. We present the theoretical foundation for designing a real‐time, 3D prostate localization system including the associated physical parameters and demonstrate the feasibility and physical limitations for such a system.PACS number: 87.53.‐j

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Intensity-modulated radiation therapy (IMRT) for prostate cancer with the use of a rectal balloon for prostate immobilization: acute toxicity and dose–volume analysis

Cited by 162 publications

References 28 publications

Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Dosimetry and preliminary acute toxicity in the first 100 men treated for prostate cancer on a randomized hypofractionation dose escalation trial

Effectiveness of a novel gas‐release endorectal balloon in the removal of rectal gas for prostate proton radiation therapy

Theoretical foundation for real‐time prostate localization using an inductively coupled transmitter and a superconducting quantum interference device (SQUID) magnetometer system

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