The influence of a rectal balloon tube as internal immobilization device on variations of volumes and dose-volume histograms during treatment course of conformal radiotherapy for prostate cancer

Wachter, Stefan De; Gerstner, Natascha; Dorner, D.; Goldner, Gregor; Colotto, Adriana; Wambersie, André; Pötter, Richard

doi:10.1016/s0360-3016(01)01821-1

Cited by 162 publications

(110 citation statements)

References 31 publications

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“…Antolak et al reported in CT studies during a course of RT that the prostate mobility was not significantly correlated with the bladder volume, however, the mobility of both the prostate and seminal vesicles significantly correlated with the rectal volume [9]. There have been several reports on the use of an endorectal balloon tube to reduce rectal gas filling, which immobilizes the prostate gland and pushes the prostate toward the pubic bone, thus resulting in rectal wall sparing and reduced rectal toxicity [13] [14]. Wachter et al reported a large experience involving the use of an endorectal balloon tube for daily prostate treatment, and maximal displacements of the posterior prostate border (>5 mm) were found in 8/10 patients without a rectal balloon and in only 2/10 patients with the balloon [14].…”

Section: Discussionmentioning

confidence: 99%

“…There have been several reports on the use of an endorectal balloon tube to reduce rectal gas filling, which immobilizes the prostate gland and pushes the prostate toward the pubic bone, thus resulting in rectal wall sparing and reduced rectal toxicity [13] [14]. Wachter et al reported a large experience involving the use of an endorectal balloon tube for daily prostate treatment, and maximal displacements of the posterior prostate border (>5 mm) were found in 8/10 patients without a rectal balloon and in only 2/10 patients with the balloon [14]. However, van Lin et al reported a clinical study of 22 patients irradiated with an endorectal balloon tube in situ and in 30 patients without an endorectal balloon tube, and the investigated endorectal balloon tube did not reduce the inter-fractional prostate motion [15].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Daily Cone-Beam Computed Tomography as Part of a Rescan Protocol for Large Offset to Reduce the Inter-Fractional Motion of the Prostate

Yamaguchi¹,

Ohguri²,

Imada³

et al. 2014

IJMPCERO

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Purpose: To prospectively analyze the inter-fractional motion of the prostate in patients with prostate cancer treated with intensity-modulated radiation therapy (IMRT) using image-guided radiotherapy (IGRT) with daily cone-beam computed tomography (CBCT) as part of a rescan protocol for large offset, and to evaluate the efficacy of our protocol. Materials and Methods: Eligible patients were treated with the following protocol: 1) magnesium oxide and dimethylpolysiloxane were administered to ensure that patients had regular bowel movements; 2) the patients were instructed to have an appropriately distended bladder during the planning CT and daily irradiation; 3) the daily CBCT image was fused with the planning CT image using the prostate outline; and 4) if large offset was recognized, a rescan CBCT image was obtained after appropriate countermeasures, such as the discharge of gas and defecation, and re-registration was performed. Three shifts for the inter-fractional motion of the prostate were analyzed, in the fractions which needed the CBCT rescan; the displacement data after the final rescan were used. Results: Sixty-one patients were eligible, and a total of 2302 fractions were available for the analysis. Rescans of the CBCT for large offset were performed in 113 (5%) of the 2302 fractions. After the first rescan, the large offset was resolved in 106 (94%) of the 113 fractions. Excessive rectal gas was the reason for the large offset in 94 (83%) of the 113 fractions. The total mean and standard deviation of the inter-fractional motion of the prostate in the AP, LR, and SI directions were 1.1 ± 2.4, −0.1 ± 2.3, and 0.7 ± 3.0 mm, respectively. Conclusion: Large offset was recognized in 5% of all fractions. Daily * Corresponding author. S. Yamaguchi et al. 194CBCT with our rescan protocol could resolve the large offset, which was mainly caused by excessive rectal gas, and it may therefore be promising to reduce the inter-fractional motion of the prostate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Daily Cone-Beam Computed Tomography as Part of a Rescan Protocol for Large Offset to Reduce the Inter-Fractional Motion of the Prostate

Yamaguchi¹,

Ohguri²,

Imada³

et al. 2014

IJMPCERO

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“…13 Rectal balloons have been used in some centers and shown to decrease the movement of the prostate. 25,26 The choice of imaging modality has also been investigated extensively. 8,13,14 It is a well known fact that CT tends to overestimate prostate volume when compared to transrectal ultrasound ͑TRUS͒ 13 and MRI.…”

Section: Discussionmentioning

confidence: 99%

CT slice index and thickness: Impact on organ contouring in radiation treatment planning for prostate cancer

Berthelet¹

2003

J. Appl. Clin. Med. Phys.

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Objective: To assess the impact of CT slice index and thickness ͑3 mm versus 5 mm͒ on ͑i͒ prostate volume, dimensions, and isocenter coordinates, ͑ii͒ bladder and rectal volumes, and ͑iii͒ DRR quality, in the treatment of prostate cancer. Methods: 16 patients with prostate cancer underwent two planning CT-scans using 3 and 5 mm slice index/thickness. Prostate, bladder, and rectum were outlined on all scans. Prostate isocenter coordinates, maximum dimensions, and volumes were compared along with bladder and rectal volumes. Bladder volumes and maximum diameters were further investigated using a second observer. A comparative analysis of DRR quality was conducted as well as a dosimetric analysis using DVH. Results: The differences in measurements of prostate volume, isocenter coordinates and maximum dimensions between the 3 and 5 mm scans, were small and not statistically significant. Similar finding was seen for rectal volume. However, bladder volume was always larger on the 3 mm scan ͑mean differenceϭ27.9 cc; SEϭ4.8 cc; 95% CI: 17.7-38.2 cc; pϽ0.001) and the findings were reproduced with the second observer ͑mean differenceϭ31.9 cc; SEϭ4.7 cc; 95% CI: 21.9-41.9 cc; p Ͻ0.001). The differences in volume are caused by a slight increase in ͑1͒ the measurement of the longitudinal dimensions on the 3 mm scans, and ͑2͒ the slice by slice measured bladder area on the 3 mm scans. The latter is due to partial volume effect. The 3 mm DRR were slightly better than the 5 mm DRR. The bladder DVH differed significantly in some patients. Conclusion: Bladder volume is significantly larger on the 3 mm scans. Differences in contoured areas may be accounted for, in part, by the partial volume effect.

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“…As an alternative, the implantation of small metal seeds into the prostate to serve as fiduciaries during daily portal imaging has also proven reliable as a means of reproducibly localising the prostate (Nederveen et al, 2003). In addition, it has been demonstrated that the use of a rectal balloon catheter can immobilise the prostate and facilitate localisation on port films potentially allowing tighter margins for the treatment volume (Wachter et al, 2002). Further, the lateral and posterior aspects of the rectal wall are partially displaced out of the high dose region by the rectal balloon, which offers the potential for significant rectal dose sparing (Patel et al, 2003).…”

Section: Clinical Applications In Prostate Cancermentioning

confidence: 99%

Intensity-modulated radiation therapy: emerging cancer treatment technology

et al. 2005

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The use of intensity-modulated radiation therapy (IMRT) is rapidly advancing in the field of radiation oncology. Intensity-modulated radiation therapy allows for improved dose conformality, thereby affording the potential to decrease the spectrum of normal tissue toxicities associated with IMRT. Preliminary results with IMRT are quite promising; however, the clinical data is relatively immature and overall patient numbers remain small. High-quality IMRT requires intensive physics support and detailed knowledge of threedimensional anatomy and patterns of tumour spread. This review focuses on basic principles, and highlights the clinical implementation of IMRT in head and neck and prostate cancer.

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The influence of a rectal balloon tube as internal immobilization device on variations of volumes and dose-volume histograms during treatment course of conformal radiotherapy for prostate cancer

Cited by 162 publications

References 31 publications

Efficacy of Daily Cone-Beam Computed Tomography as Part of a Rescan Protocol for Large Offset to Reduce the Inter-Fractional Motion of the Prostate

Efficacy of Daily Cone-Beam Computed Tomography as Part of a Rescan Protocol for Large Offset to Reduce the Inter-Fractional Motion of the Prostate

CT slice index and thickness: Impact on organ contouring in radiation treatment planning for prostate cancer

Intensity-modulated radiation therapy: emerging cancer treatment technology

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