Rectal dose sparing with a balloon catheter and ultrasound localization in conformal radiation therapy for prostate cancer

Patel, Rakesh; Orton, Nigel P.; Tomé, Wolfgang A.; Chappell, Rick; Ritter, Mark A.

doi:10.1016/s0167-8140(03)00056-2

Cited by 98 publications

(90 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although steps were taken to limit these uncertainties with the use of the rectal balloon, better daily imaging (CT) could be used to evaluate the ultrasound shifts. The rectal balloon has also been shown to reduce the volume of rectum receiving a significant radiation dose, (25) but this is counterbalanced by the discomfort of the patient, the daily reproducibility of the balloon, and the potential hypoxia caused by the pressure of the balloon, which could alter the effectiveness of the radiation (26) …”

Section: Discussionmentioning

confidence: 99%

Target localization for post‐prostatectomy patients using CT and ultrasound image guidance

Paskalev

Feigenberg

Jacob

et al. 2005

J Applied Clin Med Phys

View full text Add to dashboard Cite

We conducted a study comparing B‐mode acquisition and targeting (BAT) ultrasound alignments based on CT data in the postoperative setting. CT scans were obtained with a Primatom CT‐on‐rails on nine patients. Two CT scans were obtained each week, while setup error was minimized by BAT ultrasounds. For the first three patients, a direct comparison was performed. For the next six patients, a template based on the shifts from the week 1 CT during treatment was used for subsequent setup. Comparison of isocenter shifts between the BAT ultrasound and CT was made by the difference, absolute difference, and improvement (using CT alignments as the reference technique). A total of 90 image comparisons were made. The average interfraction motion was 3.2 mm in the lateral, 3.0 mm in the longitudinal, and 5.1 mm in the AP direction. The results suggest that the CT‐based ultrasound templates can improve the localization of the prostate bed when the initial displacements are greater than 4 mm. For initial displacements smaller than 4 mm, the technique neither improved nor worsened target localization. However, ultrasound alignments performed without the use of a template deteriorated patient positioning for two out of three patients, demonstrating that the use of a CT template was beneficial even at small initial displacements.PACS numbers: 87.53.‐j, 87.53.Kn, 87.53.Xd

show abstract

Section: Discussionmentioning

confidence: 99%

Target localization for post‐prostatectomy patients using CT and ultrasound image guidance

Paskalev

Feigenberg

Jacob

et al. 2005

J Applied Clin Med Phys

View full text Add to dashboard Cite

show abstract

“…On the one hand, it has been noted that for conventional radiotherapy techniques for prostate cancer, higher radiation doses are associated with a higher incidence of treatment-related late rectal complications [48]. While on the other hand, Patel and colleagues [49] have observed that expected late rectal complications can be limited when employing 3D conformal prostate radiotherapy by minimizing the volume of rectal wall exposed to high radiation doses by using a tissue expander (rectal balloon) and that further gains can be made when employing IMRT. Therefore, our finding that selective boosting IMRT allows us to focus boost-dose to high-risk tumor subvolumes without significantly increasing the expected late rectal complications when employing a rectal balloon is not all that surprising.…”

Section: Impact Of Loss In Specificity On Ntcpmentioning

confidence: 99%

On the impact of functional imaging accuracy on selective boosting IMRT

Kim

2009

Physica Medica

View full text Add to dashboard Cite

In order to quantify the impact of loss of functional imaging sensitivity and specificity on tumor control and normal tissue toxicity for selective boosting IMRT four selective boosting scenarios were designed: SB91-81 (EUD=91Gy for the high risk tumor subvolume and EUD=81Gy for a remaining low risk PTV (rPTV)), SB80-74, SB90-70, and risk-adaptive optimization. For each sensitivity loss level the loss in tumor control probability (ΔTCP) was calculated. For each specificity loss level, the increase in rectal and the bladder toxicity was quantified using the radiobiological indices (equivalent uniform dose (EUD) and normal tissue complication probability (NTCP)) and %-volumes irradiated.The impact of loss in sensitivity on local tumor control was maximal when the prescription dose level for rPTV had the lowest value. The SB90-70 plan had a ΔTCP= 29.6%, the SB91-81 plan had a ΔTCP = 9.5%, while for risk-adaptive optimization a ΔTCP= 4.7% was found. Independent of planning technique loss in functional imaging specificity appears to have a minimal impact on the expected normal tissue toxicity, since an increase in rectal or bladder toxicity as a function of loss in specificity was not observed. Additionally, all plans fulfilled the rectum and the bladder sparing criteria found in the literature for late rectal bleeding and genitourinary complications.Our study shows that the choice of a low-risk classification for the rPTV in selective boosting IMRT may lead to a significant loss in TCP. Furthermore, for the example considered in which normal tissue complications can be limited through the use of a tissue expander it appears that the therapeutic ratio can be improved using a functional imaging technique with a high sensitivity and limited specificity. While for cases were this is not possible an optimal balance between sensitivity and specificity has to be found.

show abstract

“…In order to localize the targets a pretreatment MVCT is obtained. A rectal displacement balloon was employed both during planning and treatment as previously described [8]. Intravenous contrast was used in all patients with a normal serum creatinine level.…”

Section: Simulation/planning Ctmentioning

confidence: 99%

“…A rectal displacement balloon was used [8] and daily pretreatment prostate and pelvis localization required. Clearly, prostate alignment and the bony anatomy alignment are not necessarily correlated [6].…”

Section: Treatment Deliverymentioning

confidence: 99%

Pelvic nodal dose escalation with prostate hypofractionation using conformal avoidance defined (H-CAD) intensity modulated radiation therapy

et al. 2006

Self Cite

View full text Add to dashboard Cite

Rectal dose sparing with a balloon catheter and ultrasound localization in conformal radiation therapy for prostate cancer

Cited by 98 publications

References 19 publications

Target localization for post‐prostatectomy patients using CT and ultrasound image guidance

Target localization for post‐prostatectomy patients using CT and ultrasound image guidance

On the impact of functional imaging accuracy on selective boosting IMRT

Pelvic nodal dose escalation with prostate hypofractionation using conformal avoidance defined (H-CAD) intensity modulated radiation therapy

Contact Info

Product

Resources

About