The Effects of Treatment Position on Normal Tissue Dose in Prostate Cancer Patient Treated with Intensity-Modulated Radiotherapy
Keywords:
Intensity-Modulated Radiotherapy, prostate, treatment positionAbstract
Purpose: To prospectively assess the effects of prone vs. supine treatment position on the dose to the rectum and bladder in prostate cancer patients treated with intensity modulated radiotherapy (IMRT). Materials and Methods: Thirteen patients with prostate cancer (7 post radical prostatectomy and 6 intact prostate) were prospectively treated with curative radiotherapy in Ramathibodi hospital between January 2013 and June 2013. All patients underwent a planning CT scan in both prone and supine treatment positions. The planning target volumes (PTV) and organ at risks (OARs) were delineated in both positions. IMRT plans were generated on each patient. A minimum of 95% of the PTV must receive 100% of the prescription dose, and the maximum dose should not exceed 107%. Dose-volume histograms (DVHs) were analyzed to evaluate rectal and bladder doses in both prone and supine positions. Results: Mean, minimum and maximum PTV doses were not different between supine and prone position. Rectal volume in prone position were significantly larger than in supine position (p = 0.01). Mean rectal doses were slightly lower in prone position but were not statistically significant. Bladder volume in prone position were significantly larger than in supine position (p = 0.0007). Mean bladder doses were statistically significant lower in prone position. Conclusions: From this study, rectal doses were not statistically different between the 2 positions, but bladder doses were lower in prone position. However, this is a result of larger bladder volume from more bladder filling. Due to more set up uncertainty and patient discomfort, we still use supine position in prostate cancer patient treated with IMRT.
References
National Cancer Institute; Ministry of Public Health, Department of Medical Services. Hospital-based cancer registry, 2009. National Cancer Institute (Thailand); 2010.
Cahlon O, Hunt M, Zelefsky MJ. Intensity-modulated radiation therapy: supportive data for prostate cancer. Semin Radiat Oncol 2008;18:48–57.
Armstrong J. Advances in radiation technology can improve survival and quality of life for cancer patients. 25th St. Luke’s lecture. Ir J Med Sci 2001;170:63-68.
RTOG contouring atlases. www.rtog.org
Perez CA, Kavanagh BD. Uterine cervix. In: Halperin EC, Perez CA, Brady LW, editors. Perez and Brady’s Principle and practice of Radiation Oncology. 5th ed. Philadelphia: Lippincott Williams &Wilkins; 2008.
RTOG 01-26 A Phase III Randomized Study of High Dose 3D- CRT/IMRT vs. Standard Dose 3D-CRT/IMRT in Patients Treated for Localized Prostate Cancer
Michalski J, Winter K, Roach M, Markoe A, Sandler HM, Ryu J, et al. Clinical Outcome of Patients Treated With 3D Conformal Radiation Therapy (3D-CRT) for Prostate Cancer on RTOG 9406. Int J Radiat Oncol Biol Phys. 2012; 83:e363-70.
Zelefsky MJ, Happersett L, Leibel SA, Burman CM, Schwarz L, Dicker AP, et al. The effect of treatment positioning on normal tissue dose in patients with prostate cancer treated with three-dimentional conformal radiotherapy. Int J Radiat Oncol Biol Phys 1997;37:13–19.
Kato T, Obata Y, Kadoya N, Fuwa N. A comparison of prone three-dimensional conformal radiotherapy with supine intensity-modulated radiotherapy for prostate cancer: which technique is more effective for rectal sparing? Br J Radiol 2009;82:654-661.
O'Neill L, Armstrong J, Buckney S, Assiri M, Cannon M, Holmberg O. A phase II trial for the optimization of treatment position in the radiation therapy of prostate cancer. Radiother Oncol. 2008;88:61-66.
McLaughlin PW, Wygoda A, Sahijdak W, Sandler HM, Marsh L, Roberson P. The effect of patient position and treatment technique in conformal treatment of prostate cancer. Int J Radiat Oncol Biol Phys 1999;45:407–413.
Weber DC, Nouet P, Rouzaud M, Miralbell R. Patient positioning in prostate radiotherapy: is prone better than supine? Int J Radiat Oncol Biol Phys. 2000; 47:365-371.
Koelbl O, Richter S,Flentje M. Influence of patient positioning on dose-volume histogram and normal tissue complication probability for small bowel and bladder in patient receiving pelvic irradiation: A prospectivestudy using 3D planning system and a radiobiological model. Int J Radiat Oncol Biol Phys. 1999;45:1193-1198.
Pinkawa M, Asadpour B, Gagel B, Piroth D M, Holy R, Eble J E. Prostate position variability and dose-volume histograms in radiotherapy for prostate cancer with full and empty bladder. Int J Radiat Oncol Biol Phys. 2006;64:856-861.
Bayley AJ, Catton CN, Haycocks T, Kelly V, Alasti H, Bristow R, et al. A randomized trial of supine vs. prone positioning in patients undergoing escalated dose conformal radiotherapy for prostate cancer. Radiother Oncol. 2004;70:37-44.
Downloads
Published
How to Cite
Issue
Section
License
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารมะเร็งวิวัฒน์ ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับ และบุคคลากรท่านอื่น ๆ ใน สมาคมฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใดๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
