TY - JOUR
T1 - The use of tissue fiducial markers in improving the accuracy of post-prostatectomy radiotherapy
AU - Chao, Michael
AU - Ho, Huong
AU - Joon, Daryl Lim
AU - Chan, Yee
AU - Spencer, Sandra
AU - Ng, Michael
AU - Wasiak, Jason
AU - Lawrentschuk, Nathan
AU - McMillan, Kevin
AU - Sengupta, Shomik
AU - Tan, Alwin
AU - Koufogiannis, George
AU - Cokelek, Margaret
AU - Foroudi, Farshad
AU - Khong, Tristan Scott
AU - Bolton, Damien
PY - 2019/3
Y1 - 2019/3
N2 -
Purpose: The aim of this retrospective study was to investigate the use of a radiopaque tissue fiducial marker (TFM) in the treatment of prostate cancer patients who undergo post-prostatectomy radiotherapy (PPRT). TFM safety, its role and benefit in quantifying the set-up uncertainties in patients undergoing PPRT image-guided radiotherapy were assessed. Materials and Methods: A total of 45 consecutive PPRT patients underwent transperineal implantation of TFM at the level of vesicourethral anastomosis in the retrovesical tissue prior to intensity-modulated radiotherapy. Prostate bed motion was calculated by measuring the position of the TFM relative to the pelvic bony anatomy on daily cone-beam computed tomography. The stability and visibility of the TFM were assessed in the initial 10 patients. Results: No postoperative complications were recorded. A total of 3,500 images were analysed. The calculated prostate bed motion for bony landmark matching relative to TFM were 2.25 mm in the left-right, 5.89 mm in the superior-inferior, and 6.59 mm in the anterior-posterior directions. A significant 36% reduction in the mean volume of rectum receiving 70 Gy (rV
70
) was achieved for a uniform planning target volume (PTV) margin of 7 mm compared with the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recommended PTV margin of 10 mm. Conclusion: The use of TFM was safe and can potentially eliminate set-up errors associated with bony landmark matching, thereby allowing for tighter PTV margins and a consequent favourable reduction in dose delivered to the bladder and rectum, with potential improvements in toxicities.
AB -
Purpose: The aim of this retrospective study was to investigate the use of a radiopaque tissue fiducial marker (TFM) in the treatment of prostate cancer patients who undergo post-prostatectomy radiotherapy (PPRT). TFM safety, its role and benefit in quantifying the set-up uncertainties in patients undergoing PPRT image-guided radiotherapy were assessed. Materials and Methods: A total of 45 consecutive PPRT patients underwent transperineal implantation of TFM at the level of vesicourethral anastomosis in the retrovesical tissue prior to intensity-modulated radiotherapy. Prostate bed motion was calculated by measuring the position of the TFM relative to the pelvic bony anatomy on daily cone-beam computed tomography. The stability and visibility of the TFM were assessed in the initial 10 patients. Results: No postoperative complications were recorded. A total of 3,500 images were analysed. The calculated prostate bed motion for bony landmark matching relative to TFM were 2.25 mm in the left-right, 5.89 mm in the superior-inferior, and 6.59 mm in the anterior-posterior directions. A significant 36% reduction in the mean volume of rectum receiving 70 Gy (rV
70
) was achieved for a uniform planning target volume (PTV) margin of 7 mm compared with the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recommended PTV margin of 10 mm. Conclusion: The use of TFM was safe and can potentially eliminate set-up errors associated with bony landmark matching, thereby allowing for tighter PTV margins and a consequent favourable reduction in dose delivered to the bladder and rectum, with potential improvements in toxicities.
KW - Fiducial marker
KW - Image-guided radiotherapy
KW - Intensity-modulated radiotherapy
KW - Prostate cancer
KW - Prostatectomy
UR - http://www.scopus.com/inward/record.url?scp=85065474253&partnerID=8YFLogxK
U2 - 10.3857/roj.2018.00556
DO - 10.3857/roj.2018.00556
M3 - Article
C2 - 30947480
AN - SCOPUS:85065474253
VL - 37
SP - 43
EP - 50
JO - Radiation Oncology Journal
JF - Radiation Oncology Journal
SN - 2234-1900
IS - 1
ER -