Prostate position variability and dose–volume histograms in radiotherapy for prostate cancer with full and empty bladder

Pinkawa, Michael; Asadpour, Branka; Gagel, Bernd; Piroth, Marc D.; Holý, Richard; Eble, Michael J.

doi:10.1016/j.ijrobp.2005.08.016

Cited by 93 publications

(53 citation statements)

References 18 publications

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“…NIDDM, however, was included due to the impact previously shown [9,10]. The negative correlation between the bladder volume and the dosimetric factor PC1 is expected due to the inclusion of larger relative bladder volume in the high dose region in patients with smaller/empty bladder [30]. As posttreatment symptomology is more logically explained by the bladder dosimetry rather than the bladder size itself, only PC1 is included as a candidate.…”

Section: Variable Selection and Multivariate Analysismentioning

confidence: 99%

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

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Urinary symptoms (frequency, incontinence, dysuria and haematuria) were prospectively assessed using LENT-SOMA to a median of 72 months. The endpoints assessed were prevalence (grade≥1) at the end of radiotherapy (representing acute symptoms), at 18-, 36-and 54-month follow-ups (representing late symptoms) and peak late incidence including only grade≥2. Impact of factors were assessed using multivariate logistic regression models with correction for over-optimism. Results: Baseline symptoms, non-insulin dependent diabetes mellitus, age and PC1 (correlated to the mean dose) impact symptoms at >1 timepoints. Associations at a single timepoint were found for cerebrovascular condition, ECOG status and non-steroidal anti-inflammatory drug intake. Peak incidence analysis shows the impact of baseline, bowel and cerebrovascular condition and smoking status. Conclusions:The prevalence and incidence analysis provide a complementary view for urinary symptom prediction. Sustained impacts across time points were found for several factors while some associations were not repeated at different time points suggesting poorer or transient impact.4

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Section: Variable Selection and Multivariate Analysismentioning

confidence: 99%

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Yahya

Ebert

Bulsara

et al. 2015

Radiotherapy and Oncology

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“…For men receiving dose-escalated radical prostate radiotherapy, a consistent bladder volume between planning and treatment is vital. Although there are differing opinions on the influence of bladder volume on interfraction prostate position [1][2][3][4][5][6][7], the influence of the irradiated bladder volume on acute and late urinary [8] and bowel toxicity [2,9] has been well documented.Despite the apparent importance of controlling bladder volume for prostate radiotherapy, there is surprisingly limited research into the provision of bladder-filling instructions that produce acceptable dose-volume histograms (DVHs) and provide a reproducible bladder volume from planning through to treatment [1-2, 10, 11] rather than an unreliable and misleading snapshot at the time of planning.This study was designed to first validate bladder volume measurements using a non-invasive transabdominal bladder ultrasound device (BVI 6400 Bladderscan, Verathon Medical UK, Sandford, UK) before using it to evaluate the effectiveness of standardised bladder-filling instructions in achieving a consistent and reproducible bladder volume from the time of planning and during each daily fraction of radical radiotherapy for prostate cancer. The data obtained would then be used to inform changes in bladder-filling instructions before future re-evaluation.…”

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confidence: 99%

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Assessing the daily consistency of bladder filling using an ultrasonic Bladderscan device in men receiving radical conformal radiotherapy for prostate cancer

Hynds¹,

McGarry²,

Mitchell³

et al. 2011

BJR

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Objective: Consistency in target organ and organ at risk position from planning to treatment is an important basic principle of radiotherapy. This study evaluates the effectiveness of bladder-filling instructions in achieving a consistent and reproducible bladder volume at the time of planning CT and daily during the course of radical radiotherapy for prostate cancer. It also assessed the rate of bladder filling before and at the end of radiotherapy. Methods: 30 men attending for radiation therapy planning for prostate cancer received written and verbal bladder-filling instructions. They had their bladder volume assessed using a bladder ultrasound scanner post-void, immediately prior to planning CT scan and then daily immediately prior to treatment while in the therapy position. The inflow was calculated using the void and full bladder volumes and the time for the bladder to fill. Results: The mean bladder volume at the time of planning was 282 ml (range 89-608 ml, standard deviation (SD)5144.5 ml). This fell during treatment, with a mean value for all treatments of 189 ml (range 11-781 ml, SD5134 ml). During radiotherapy, 76% (828/1090), 53% (579/1090) and 36% (393/1090) of bladder volumes had .50 ml, .100 ml and .150 ml difference, respectively when compared with their volume at the time of planning. Inflow reduced from 4.6 ml min -1 , SD52.9 min -1 at planning to 2.5 min -1 , SD51.8 min -1 after radiotherapy. Conclusion: The Bladderscan device (BVI 6400 Bladderscan, Verathon Medical UK, Sandford, UK) provides an effective means of assessing bladder volume prior to radiotherapy for prostate cancer. The evaluated bladder-filling protocol does not produce consistent, reproducible bladder volumes for radiotherapy. Reproducibility of target volume position is a fundamental component of external beam radiotherapy at any site, but is of particular importance where a doseescalated regimen is being employed and where the surrounding organs are both dose and volume sensitive. For men receiving dose-escalated radical prostate radiotherapy, a consistent bladder volume between planning and treatment is vital. Although there are differing opinions on the influence of bladder volume on interfraction prostate position [1][2][3][4][5][6][7], the influence of the irradiated bladder volume on acute and late urinary [8] and bowel toxicity [2,9] has been well documented.Despite the apparent importance of controlling bladder volume for prostate radiotherapy, there is surprisingly limited research into the provision of bladder-filling instructions that produce acceptable dose-volume histograms (DVHs) and provide a reproducible bladder volume from planning through to treatment [1-2, 10, 11] rather than an unreliable and misleading snapshot at the time of planning.This study was designed to first validate bladder volume measurements using a non-invasive transabdominal bladder ultrasound device (BVI 6400 Bladderscan, Verathon Medical UK, Sandford, UK) before using it to evaluate the effectiveness of standardised bladder-filling instru...

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“…dozimetrik çalışmalarında bağırsak dozunun; boş mesane ile tedaviye giren hastalarda olguların %37'sinde, dolu mesane ile girenlerde ise sadece %3'ünde tanımlanan dozun %90'ına ulaştığını gözlemişlerdir. [26] Yoğunluk ayarlı radyoterapi ve VMAT ile tü- mör çevresindeki dokularda hızlı doz düşüşü meydana gelmektedir. Bundan dolayı tedavi başarısı RT dozunun doğru yere verilebilmesine bağlıdır.…”

Section: Discussionunclassified

Acute toxicity in prostate carcinoma patients treated with kV-CBCT guided IMRT/VMAT

Özdemir¹

2014

TJ Oncol

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obJecTIveSTo evaluate acute toxicity of image guided IMRT/VMAT in prostate carcinoma patients. MeTHodSAcute toxicities of 101 prostate carcinoma patients, treated with radical radiotherapy were evaluated. Prostate, prostate and seminal vesicles, and pelvic lymph nodes were enrolled into the treatment volume in 50, 40 and 11cases respectively. All patients were planned with Eclipse treatment planning system using dynamic IMRT/ VMAT. The median doses to the planning target volumes of prostate, seminal vesicles and pelvic lymphatics were 76Gy, 56Gy and 54Gy respectively, delivered simultaneously. All patients were observed per week during radiotherapy and at 1st and 3rd month following completion of therapy. Acute toxicities were graded according to the RTOG scoring criteria. reSULTSGrade 2 and 1genitourinary acute toxicity were observed in 3 and 57 patients, respectively. Grade1 gastrointestinal toxicity was detected in 15 patients, 3 patients developed grade1 skin reaction. Grade 1 leukopenia was detected in 2 cases. No grade 3-4 toxicity was observed. coNcLUSIoNIn prostate cancer, higher doses radiotherapy with kV-CBCT guided IMRT/VMAT technique was given more accurately and well tolerated. Expected side effects depending on size of irradiated volume with pelvic radiotherapy, were not observed.

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Prostate position variability and dose–volume histograms in radiotherapy for prostate cancer with full and empty bladder

Cited by 93 publications

References 18 publications

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Dosimetry, clinical factors and medication intake influencing urinary symptoms after prostate radiotherapy: An analysis of data from the RADAR prostate radiotherapy trial

Assessing the daily consistency of bladder filling using an ultrasonic Bladderscan device in men receiving radical conformal radiotherapy for prostate cancer

Acute toxicity in prostate carcinoma patients treated with kV-CBCT guided IMRT/VMAT

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