When Should the Seminal Vesicles be Included in the Target Volume in Prostate Radiotherapy?

Bayman, N.; Wylie, James

doi:10.1016/j.clon.2007.03.005

Cited by 28 publications

(20 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of proctitis appears to be dependent upon both the total radiation dose and the volume of the rectum in the high dose area [ 18 ]. Technical factors such as treatment of the proximal seminal vesicles [ 19 ] and expansion of planning target volume (PTV) to compensate for intra-fraction prostate motion [ 20 ] may contribute to the severity of rectal toxicities. To minimize bowel toxicity, it is currently recommended that the volume of the rectum receiving > 75 Gray (Gy) be limited to < 10% with conventionally fractionated radiation therapy [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Proctitis following stereotactic body radiation therapy for prostate cancer

et al. 2014

View full text Add to dashboard Cite

BackgroundProctitis after radiation therapy for prostate cancer remains an ongoing clinical challenge and critical quality of life issue. SBRT could minimize rectal toxicity by reducing the volume of rectum receiving high radiation doses and offers the potential radiobiologic benefits of hypofractionation. This study sought to evaluate the incidence and severity of proctitis following SBRT for prostate cancer.MethodsBetween February 2008 and July 2011, 269 men with clinically localized prostate cancer were treated definitively with SBRT monotherapy at Georgetown University Hospital. All patients were treated to 35-36.25Gy in 5 fractions delivered with the CyberKnife Radiosurgical System (Accuray). Rectal bleeding was recorded and scored using the CTCAE v.4. Telangiectasias were graded using the Vienna Rectoscopy Score (VRS). Proctitis was assessed via the Bowel domain of the Expanded Prostate Index Composite (EPIC)-26 at baseline and at 1, 3, 6, 9, 12, 18 and 24 months post-SBRT.ResultsThe median age was 69 years with a median prostate volume of 39 cc. The median follow-up was 3.9 years with a minimum follow-up of two years. The 2-year actuarial incidence of late rectal bleeding ≥ grade 2 was 1.5%. Endoscopy revealed VRS Grade 2 rectal telangiectasias in 11% of patients. All proctitis symptoms increased at one month post-SBRT but returned to near-baseline with longer follow-up. The most bothersome symptoms were bowel urgency and frequency. At one month post-SBRT, 11.2% and 8.5% of patients reported a moderate to big problem with bowel urgency and frequency, respectively. The EPIC bowel summary scores declined transiently at 1 month and experienced a second, more protracted decline between 6 months and 18 months before returning to near-baseline at two years post-SBRT. Prior to treatment, 4.1% of men felt their bowel function was a moderate to big problem which increased to 11.5% one month post-SBRT but returned to near-baseline at two years post-SBRT.ConclusionsIn this single institution cohort, the rate and severity of proctitis observed following SBRT is low. QOL decreased on follow-up; however, our results compare favorably to those reported for patients treated with alternative radiation modalities. Future prospective randomized studies are needed to confirm these observations.

show abstract

Section: Introductionmentioning

confidence: 99%

Proctitis following stereotactic body radiation therapy for prostate cancer

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Guidelines state however that either the proximal half [1], the proximal 1–2 cm [9] or at least the proximal 1 cm of SV should be included in the high risk CTV and treated to full dose [10]. A frequently quoted study from the William Beaumont Hospital looked at 81 positive SV from clinically staged ≤ T2c prostate cancer patients who subsequently underwent prostatectomy [11].…”

Section: Discussionmentioning

confidence: 99%

“…Bayman et al conducted a review of prostatectomy series and revealed that the risk of SV invasion in intermediate risk patients is between 13 and 22% [1]. As a result, recommendations were made to encompass SV in patients with at least one risk factor of PSA >10, Gleason Score ≥7, T stage >2A, or percentage of positive biopsy >50%.…”

Section: Introductionmentioning

confidence: 99%

Seminal vesicle interfraction displacement and margins in image guided radiotherapy for prostate cancer

et al. 2012

View full text Add to dashboard Cite

BackgroundTo analyze interfraction motion of seminal vesicles (SV), and its motion relative to rectal and bladder filling.Methods and MaterialsSV and prostate were contoured on 771 daily computed tomography “on rails” scans from 24 prostate cancer patients undergoing radiotherapy. Random and systematic errors for SV centroid displacement were measured relative to the prostate centroid. Margins required for complete geometric coverage of SV were determined using isotropic expansion of reference contours. SV motion relative to rectum and bladder was determined.ResultsSystematic error for the SV was 1.9 mm left-right (LR), 2.9 mm anterior-posterior (AP) and 3.6 mm superior-inferior (SI). Random error was 1.4 mm (LR), 2.7 mm (AP) and 2.1 mm (SI). 10 mm margins covered the entire left SV and right SV on at least 90% of fractions in 50% and 33% of patients and 15 mm margins covered 88% and 79% respectively. SV AP movement correlated with movement of the most posterior point of the bladder (mean R2 = 0.46, SD = 0.24) and rectal area (mean R2 = 0.38, SD = 0.21).ConclusionsConsiderable interfraction displacement of SV was observed in this cohort of patients. Bladder and rectal parameters correlated with SV movement.

show abstract

“…For patients with intermediate and high risk prostate cancer, seminal vesicles (SV) have a higher risk of invasion and are recommended to be included to the clinical target volume (CTV). [6][7] However, the prostate and SV may be subject to inter-and intrafractional motions because of the changes in rectal and bladder filling. These displacements are important when treating prostate and SV with simultaneous IMRT irradiation technique due to the sharp dose gradients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Interfractional Movement of the Seminal Vesicle and Dose Variations with IGRT Throughout the Prostate Cancer Radiotherapy.

Ergen¹

2016

UHOD

View full text Add to dashboard Cite

To validate the actual cumulative doses delivered to the seminal vesicle (SV) depending on the organ movement using kV-Cone Beam CT (kV-CBCT) datasets acquired during prostate image-guided radiation therapy. Ten patients with intermediate risk prostate cancer treated with IMRT were included in this study. Both the prostate and the first 2 cm of the SV were included in the CTV. PTV margin was 8 mm in all directions except posterior, where it was 5 mm. Sixteen kV-CBCT scans per patient were used for assessments. After each kV-CBCT was matched with the planning CT based on prostate, the SV were recontoured as proximal, distal SV and both of them together (the whole SV). Actual delivered doses to the SV were assessed by means of DVH. The variations in certain dosevolume parameters were analyzed using the Student's test. Systematic and random errors of the SV and margins were assessed using the van-Herk formula. We observed that the SV movement in the anterior-posterior direction was significantly more compared to superior-inferior and left-right direction. The dose volume variations for the whole SV (D98%, D50%, D2%) and the distal SV (D98%, D95%, D50%) were significantly different than the planned doses. However, both the whole SV and the distal SV received the prescribed dose. Although it seems that there is a need to give larger margin to the SV in posterior direction, the actual cumulative doses delivered to SV throughout the treatment were within the prescribed dose.Keywords: Image guided radiation therapy, Interfraction motions, kV-CBCT, Prostate cancer, Seminal vesicle ÖZET Prostat kanseri Radyoterapisi Sırasında Fraksiyonlar Arası Seminal Vezikül Hareketleri ve Doz Değişimlerinin IGRT ile DeğerlendirilmesiBu çalışmanın amacı, kV-Cone Beam CT (kV-CBCT) ile görüntü kılavuzluğunda prostat kanseri radyoterapisinde organ hareketine bağlı olarak seminal veziküllerin aldığı kümülatif dozların doğruluğunun değerlendirilmesidir. Çalışmamıza IMRT tekniği ile tedavi edilmiş orta risk prostat kanserli on hasta dahil edilmiştir. Prostat ve seminal vesiküllerin ilk 2 cm'lik bölümü CTV'ye dahil edilmiştir. Prostat ve SV'e posterior yönden 5 mm, diğer yönlerden 8 mm PTV marjı verilmiştir. Her hastadan 16 kV-CBCT alınmış ve SV'ye verilen marjın yeterli olup olmadığını saptamak için seçilen kV-CBCT görüntüleri ile planlama BT görüntüleri prostat referans alınarak offline eşleştirilmiştir. Seminal veziküller, proksimal-distal SV şeklinde ayrı ayrı ve her ikisi birlikte tüm SV olacak şekilde yeniden konturlanmıştır. Seminal veziküllerin aldığı doz DVH yardımı ile değerlendirilmiştir. Doz volüm histogramındaki değişiklikler Student test ile analiz edilmiştir. Sistematik ve random hatalar van-Herk formülü ile değerlendirilerek gerekli emniyet marjları bulunmuştur. Seminal vezikül hareketinin alt-üst ve sağ-sol yöne kıyasla ön-arka eksende daha fazla olduğu görülmüştür. Tüm SV için (D98% D50,% D2%) ve distal SV için doz volüm değişiklikleri (D98% D95,% D50%) planlanan dozlardan önemli ölçüde farklı bulunmuştur. Bununla bir...

show abstract

When Should the Seminal Vesicles be Included in the Target Volume in Prostate Radiotherapy?

Cited by 28 publications

References 34 publications

Proctitis following stereotactic body radiation therapy for prostate cancer

Proctitis following stereotactic body radiation therapy for prostate cancer

Seminal vesicle interfraction displacement and margins in image guided radiotherapy for prostate cancer

Evaluation of Interfractional Movement of the Seminal Vesicle and Dose Variations with IGRT Throughout the Prostate Cancer Radiotherapy.

Contact Info

Product

Resources

About