Potential for Higher Treatment Failure in Obese Patients: Correlation of Elevated Body Mass Index and Increased Daily Prostate Deviations From the Radiation Beam Isocenters in an Analysis of 1,465 Computed Tomographic Images

Wong, James R.; Gao, Z; Merrick, S.; Wilson, Paula; Uematsu, Minoru; Woo, Kevin; Cheng, Chee Wai

doi:10.1016/j.ijrobp.2008.07.049

Cited by 66 publications

(49 citation statements)

References 24 publications

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“…Wong et al [134] found that there was a shift in the delivery of external beam radiation in obese patients, resulting in the target location not receiving the full dose. In addition, research has suggested that, among men undergoing prostatectomy, surgical margins may not be as clean in obese men and that they may have fewer nerve bundles preserved [135] .…”

Section: Chemotherapymentioning

confidence: 99%

Obesity, Diabetes, the Cardiorenal Syndrome, and Risk for Cancer

et al. 2012

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Numerous epidemiological studies confirm that the prevalence of obesity and the cardiorenal metabolic syndrome (CRS) is extraordinarily high and that the rates have increased dramatically in the last three decades. In addition, epidemiological data demonstrate that obesity, the CRS, and diabetes are inextricably linked and are all associated with an increased incidence of a number of solid tissue cancers. The mechanisms for this association have been examined, including, but not limited to, higher levels of insulin and free levels of insulin-like growth factor and insulin resistance in obesity and the CRS. Mortality, morbidity, and the associated health care costs which are the link between obesity, the CRS, and diabetes are just beginning to be examined. In addition, we review the advantages of implementing lifestyle and surgical changes to modify obesity, lessening the development of the CRS, diabetes, and associated cancers. Epidemiological data regarding the general mechanisms of the pathogenesis of cancers associated with obesity, the CRS, and diabetes (specifically colon, pancreas, esophageal, liver, breast, prostate, thyroid, and renal carcinomas) are reviewed. The mechanisms by which obesity and other components of the CRS contribute to the pathogenesis of these cancers, such as hormone alterations and insulin-and insulin-like growth factor-dependent pathways of tumor pathogenesis, include the attending roles of inflammation and oxidative stress. Emphasis has been placed

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Section: Chemotherapymentioning

confidence: 99%

Obesity, Diabetes, the Cardiorenal Syndrome, and Risk for Cancer

et al. 2012

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“…Obesity has been identified as an independent risk factor for increased biochemical relapse after EBRT [6][7][8][9] but not after permanent low-dose-rate BT. [12][13][14] This might be because accurate dose delivery can be compromised in obese patients by spatial shifts in prostate position and setup errors greater than 10 mm 29,30 whereas similar problems are not present in BT.…”

Section: à2mentioning

confidence: 99%

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Zilli

Nguyễn

et al. 2011

Int J Obes

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Objective: We tested the potential role of abdominal visceral (VAT) and subcutaneous (SAT) adipose tissues, waist circumference (WC) and body mass index (BMI) as prognostic factors in patients with intermediate-risk prostate cancer (clinical stage T1b-2b, and Gleason Score (GS) ¼ 7 and prostate-specific antigen PSA level o15 ng ml À1 , or GS p6 and PSA between 10 and 20 ng ml À1 ) treated with ultrasound-based image-guided radiotherapy. Methods: VAT, SAT and WC (measured from planning abdominal computed tomography) and BMI were compared with clinical and pathologic factors using univariate analyses. Cox regression analyses were performed to evaluate whether obesity indices significantly predicted biochemical disease free-survival (bDFS). Results: Of the 112 eligible patients, 30 (27%) were obese. Median BMI at baseline was 27.5 kg m À2 (range, 19.2-51.5 kg m À2 ). Greater abdominal adiposity, WC and BMI were significantly associated with younger age at diagnosis and increased prostate volume (P ¼ 0.003 and P ¼ 0.002, respectively). No significant correlation between obesity measures and T-stage, GS, PSA or percentage of positive cores at biopsy was found. On Cox regression analyses, none of the obesity measures predicted for bDFS. No association was observed between obesity indices and surrogate markers of biochemical failure as PSA nadir (nPSA) or time to nPSA. Conclusions: Abdominal adiposity, WC and BMI are associated with younger age at diagnosis and greater prostate volume but not with an increased risk of biochemical failure in patients with intermediate-risk prostate cancer.

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“…Therefore it may be more difficult to be immobilised and this could be more significant in a larger sized breast and/or patient. Several studies have reported the correlation between body mass index (BMI) and setup errors for various tumour sites including endometrial,16 prostate17 and abdominal18 malignancies, however, correlation in breast RT has not been reported. Assessment of the impact of breast size and BMI on setup errors for breast RT is necessary.…”

Section: Introductionmentioning

confidence: 99%

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy

et al. 2016

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IntroductionTo compare the differences in setup errors measured with electronic portal image (EPI) and cone‐beam computed tomography (CBCT) in patients undergoing tangential breast radiotherapy (RT). Relationship between setup errors, body mass index (BMI) and breast size was assessed.MethodsTwenty‐five patients undergoing postoperative RT to the breast were consented for this study. Weekly CBCT scans were acquired and retrospectively registered to the planning CT in three dimensions, first using bony anatomy for bony registration (CBCT‐B) and again using breast tissue outline for soft tissue registration (CBCT‐S). Digitally reconstructed radiographs (DRR) generated from CBCT to simulate EPI were compared to the planning DRR using bony anatomy in the V (parallel to the cranio‐caudal axis) and U (perpendicular to V) planes. The systematic (Σ) and random (σ) errors were calculated and correlated with BMI and breast size.ResultsThe systematic and random errors for EPI (Σ V = 3.7 mm, Σ U = 2.8 mm and σ V = 2.9 mm, σ U = 2.5) and CBCT‐B (Σ V = 3.5 mm, Σ U = 3.4 mm and σ V = 2.8 mm, σ U = 2.8) were of similar magnitude in the V and U planes. Similarly, the differences in setup errors for CBCT‐B and CBCT‐S in three dimensions were less than 1 mm. Only CBCT‐S setup error correlated with BMI and breast size.Conclusions CBCT and EPI show insignificant variation in their ability to detect setup error. These findings suggest no significant differences that would make one modality considered superior over the other and EPI should remain the standard of care for most patients. However, there is a correlation with breast size, BMI and setup error as detected by CBCT‐S, justifying the use of CBCT‐S for larger patients.

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Potential for Higher Treatment Failure in Obese Patients: Correlation of Elevated Body Mass Index and Increased Daily Prostate Deviations From the Radiation Beam Isocenters in an Analysis of 1,465 Computed Tomographic Images

Cited by 66 publications

References 24 publications

Obesity, Diabetes, the Cardiorenal Syndrome, and Risk for Cancer

Obesity, Diabetes, the Cardiorenal Syndrome, and Risk for Cancer

Prognostic impact of abdominal adiposity, waist circumference and body mass index in patients with intermediate-risk prostate cancer treated with radiotherapy

Comparison of setup accuracy of three different image assessment methods for tangential breast radiotherapy

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