跳至主要内容

Construction of a Simple Rectum Model Using Image Guidance in Prostate Patients Treated with 3D Conformal Radiotherapy

Read full paper at：
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50452#.VD9yDlfHRK0

Purpose: To evaluate the performance of a rectum model in predicting late rectal toxicity of prostate patients undergoing 3D conformal radiation therapy while following a dietary protocol combined with image guidance. Methods: A linear accelerator equipped with a Cone Beam Computed Tomography (CBCT) system was used to treat 20 patients who were following a dietary protocol. The set-up was verified by co-registering CBCT scans with the planning CT scan (pCT). A mean dose volume histogram (< DVH >) as the arithmetical mean of the rectum DVHs from each CBCT scan was obtained. A suitably defined 3D rectum model (Average Rectum, AR) was defined and its DVH (DVHAR) was calculated. DVHs were also evaluated for the first five CBCT scans using both methods (< DVH5 > and DVHAR5). The Lyman-Kutcher-Burman NTCP model with QUANTEC parameters was used to compare the calculated DVHs. The QUANTEC dose values were used to describe the time behaviour of the relative volumes using the Gamma Distribution for the frequency of the relative rectum volumes at each QUANTEC dose value. Results: No statistically significant differences between NTCPAR5 and NTCPAR and between NTCP< DVH5 > and NTCP< DVH > were found. The best agreement with the observed toxicity rate (0%) was obtained form DVHAR. The Gamma Distributions of the rectum volumes at the QUANTEC dose levels were found to be highly variable among the patients. Conclusions: Both dietary protocol and image guidance were found effective in limiting late rectal toxicity. AR was a better predictor for late rectal toxicity and better described the rectum volume during the treatment course. Finally, from the Gamma distributions, and from our toxicity data, we can suggest V75 as the best predictor of late rectal toxicity.
Cite this paper
D’Andrea, M. , Falco, M. , Fedele, D. , Ponti, E. , Tolu, B. , Cristino, D. , Barbarino, R. , Murro, L. , Tortorelli, G. , Duggento, A. , Bagalà, P. , Guerrisi, M. and Santoni, R. (2014) Construction of a Simple Rectum Model Using Image Guidance in Prostate Patients Treated with 3D Conformal Radiotherapy. Journal of Cancer Therapy, 5, 1039-1048. doi: 10.4236/jct.2014.512109. 
 

[1] Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J. and Thun, M.J. (2009) Cancer Statistics, 2009. CA: A Cancer Journal for Clinicians, 59, 225-249. http://dx.doi.org/10.3322/caac.20006
[2] Ferlay, J., Autier, P., Boniol, M., Heanue, M., Colombet, M. and Boyle, P. (2007) Estimates of Cancer Incidence and mortality in Europe in 2006. Annals of Oncology, 18, 581-592.
http://dx.doi.org/10.1093/annonc/mdl498
[3] Peschel, R.E. and Colberg, J.W. (2003) Surgery, Brachytherapy, and External-Beam Radiotherapy for Early Prostate Cancer. Lancet Oncology, 4, 233-241.
http://dx.doi.org/10.1016/S1470-2045(03)01035-0
[4] Kuban, D.A., Tucker, S.L., Dong, L., Starkschall, G., Huang, E.H., Cheung, M.R., Lee, A.K. and Pollack, A. (2008) Long-Term Results of the M. D. Anderson Randomized Dose-Escalation Trial for Prostate Cancer. International Journal of Radiation Oncology*Biology*Physics, 70, 67-74.
http://dx.doi.org/10.1016/j.ijrobp.2007.06.054
[5] Kupelian, P.A., Reddy, C.A., Carlson, T.P., Altsman, K.A. and Willoughby, T.R. (2002) Preliminary observations on biochemical relapse-free survival rates after short-course intensity-modulated radiotherapy (70 Gy at 2.5 Gy/fraction) for localized prostate cancer. International Journal of Radiation Oncology*Biology*Physics, 53, 904-912. http://dx.doi.org/10.1016/S0360-3016(02)02836-5
[6] Herold, D.M., Hanlon, A.L. and Hanks, G.E. (1999) Diabetes Mellitus: A Predictor for Late Radiation Morbidity. International Journal of Radiation Oncology*Biology*Physics, 43, 475-479.
http://dx.doi.org/10.1016/S0360-3016(98)00460-X
[7] Peeters, S.T., Lebesque, J.V., Heemsbergen, W.D., van Putten, W.L., Slot, A., Dielwart, M.F., et al. (2006) Localized Volume Effects for Late Rectal and Anal Toxicity after Radiotherapy for Prostate Cancer. International Journal of Radiation Oncology*Biology*Physics, 64, 1151-1161.
http://dx.doi.org/10.1016/j.ijrobp.2005.10.002
[8] Vavassori, V., Fiorino, C., Rancati, T., Magli, A., Fellin, G., Baccolini, M., et al. (2007) Predictors for Rectal and Intestinal Acute Toxicities during Prostate Cancer High-Dose 3D-CRT: Results of a Prospective Multicenter Study. International Journal of Radiation Oncology*Biology*Physics, 67, 1401-1410. http://dx.doi.org/10.1016/j.ijrobp.2006.10.040
[9] Liu, M., Pickles, T., Agranovich, A., Berthelet, E., Duncan, G., Keyes, M., et al. (2004) Impact of Neoadjuvant Androgen Ablation and Other Factors on Late Toxicity after External Beam Prostate Radiotherapy. International Journal of Radiation Oncology*Biology*Physics, 58, 59-67.
[10] Boersma, L.J., van den Brink, M., Bruce, A.M., Shouman, T., Gras, L., Annet te Velde, et al. (1998) Estimation of the Incidence of Late Bladder and Rectum Complications after High-Dose (70-78 Gy) Conformal Radiotherapy for Prostate Cancer, Using Dose-Volume Histograms. International Journal of Radiation Oncology*Biology*Physics, 41, 83-92.
[11] Fiorino, C., Sanguineti, G., Cozzarini, C., Fellin, G., Foppiano, F., Menegotti, L., et al. (2003) Rectal Dose-Volume Constraints in High-Dose Conformal Radiotherapy for Localized Prostate Cancer. International Journal of Radiation Oncology*Biology*Physics, 57, 953-962.
[12] Rancati, T., Fiorino, C., Gagliardi, G., Cattaneo, G.M., Sanguineti, G., Borca, V.C., et al. (2004) Fitting Late Rectal Bleeding Data Using Different NTCP Models: Results from an Italian Multi-Centric Study (AIROPROS0101). Radiotherapy and Oncology, 73, 21-32.
http://dx.doi.org/10.1016/j.radonc.2004.08.013
[13] Fellin, G., Fiorino, C., Rancati, T., Valvassori, V., Barra, S., Cagna, E., et al. (2008) Late Rectal Bleeding after Conformal Radiotherapy for Prostate Cancer: NTCP Modelling. Radiotherapy and Oncology, 88, S332-S333.
[14] Fiorino, C., Fellin, G. and Rancati, T. (2008) Clinical and Dosimetric Predictors of Late Rectal Syndrome after 3DCRT for Localized Prostate Cancer: Preliminary Results of a Multicenter Prospective Study. International Journal of Radiation Oncology*Biology*Physics, 70, 1130-1137.
[15] Gulliford, S.L., Foo, K., Morgan, R.C., Aird, E.G., Bidmead, A.M., Critchley, H., et al. (2010) Volume Constraints to Reduce Rectal Side Effects from Prostate Radiotherapy: Evidence from mrc rt01 Trial isrctn 47772397. International Journal of Radiation Oncology*Biology*Physics, 76, 747-754.
[16] Michalski, J.M., Gay, H., Jackson, A., Tucker, S.L. and Deasy, J.O. (2010) Radiation Dose-Volume Effects in Radiation-Induced Rectal Injury. International Journal of Radiation Oncology Biology Physics, 76, S123-S129.
[17] Rancati, T., Fiorino, C., Fellin, G., Vavassori, V., Cagna, E., Borca, V.C., et al. (2011) Inclusion of Clinical Risk Factors into NTCP Modelling of Late Rectal Toxicity after High Dose Radiotherapy for Prostate Cancer. Radiotherapy and Oncology, 100, 124-130.
http://dx.doi.org/10.1016/j.radonc.2011.06.032
[18] Onal, C., Topkan, E., Efe, E., Yavuz, M., Sonmez, S. and Yavu, A. (2009) Comparison of Rectal Volume Definition Techniques and Their Influence on Rectal Toxicity in Patients with Prostate Cancer Treated with 3D Conformal Radiotherapy: A Dose-Volume Analysis. Radiation Oncology, 4, 14.
[19] Boehmer, D., Kuczer, D., Badakhshi, H., Stiefel, S., Kuschke, W., Wernecke, K.D. and Budach, V. (2006) Influence of Organ at Risk Definition on Rectal Dose-Volume Histograms in Patients with Prostate Cancer Undergoing ExternalBeam Radiotherapy. Strahlentherapie und Onkologie, 82, 277-282.
http://dx.doi.org/10.1007/s00066-006-1462-7
[20] O’Donnel, H.E., Finnegan, K., Eliades, H., Oliveros, S. and Plawman, P.N. (2008) Re-Defining Rectal Volume and DVH for Analysis of Rectal Morbidity Risk after Radiotherapy for Early Prostate Cancer. The British Journal of Radiology, 81, 327-332. http://dx.doi.org/10.1259/bjr/75868623
[21] Kupelian, A.P., Langen, K.M., Willoughby, T.R., Zeidan, O.A. and Sanford, L.M. (2008) Image-Guided Radiotherapy for Localized Prostate Cancer: Treating a Moving Target. Seminars in Radiation Oncology, 18, 58-66. http://dx.doi.org/10.1016/j.semradonc.2007.09.008
[22] Huang, K., Palma, D.A., Scott, D., McGregor, D., Gaede, S., Yartsev, S., Bauman, G., Louie, A.V. and Rodrigues, G. (2012) Inter-and Intrafraction Uncertainty in Prostate Bed Image-Guided Radiotherapy. International Journal of Radiation Oncology*Biology*Physics, 84, 402-407.
http://dx.doi.org/10.1016/j.ijrobp.2011.12.035
[23] Thor, M., Bentzen, L., Hysing, L.B., Ekanger, C., Helle, S.I., Karlsdóttir, á., et al. (2013) Prediction of Rectum and Bladder Morbidity Following Radiotherapy of Prostate Cancer Based on Motion-Inclusive Dose Distributions. Radiotherapy and Oncology, 107, 147-152.
http://dx.doi.org/10.1016/j.radonc.2013.03.029
[24] Thor, M., V?th, M., Karlsdottir, á. and Muren, L.P. (2010) Rectum Motion and Morbidity Prediction: Improving Correlation between Late Morbidity and DVH Parameters through Use of Rectum Planning Organ at Risk Volumes. Acta Oncologica, 49, 1061-1068.
http://dx.doi.org/10.3109/0284186X.2010.505200
[25] Smitsmans, M.H.P., Floris, J.P., de Bois, R.T.T.J., Wilma, D., Heemsbergen, W.D., Sonke, J.J., Lebesque, J.V., et al. (2008) The Influence of a Dietary Protocol on Cone Beam CT-Guided Radiotherapy for Prostate Cancer Patients. International Journal of Radiation Oncology*Biology*Physics, 71, 1279-1286.
[26] Falco, M.D., D’Andrea, M., Fedele, D., Barbarino, R., Benassi, M., Giudice, E., et al. (2011) Preliminary Experience of a Predictive Model to Define Rectal Volume and Rectal Dose during the Treatment of Prostate Cancer. The British Journal of Radiology, 84, 819-825.
http://dx.doi.org/10.1259/bjr/25741415
[27] Kutcher, G.J., Burman, C., Brewster, L., Goitein, M. and Mohan, R. (1991) Histogram Reduction Method for Calculating Complication Probabilities for Three Dimensional Treatment Planning Evaluations. International Journal of Radiation Oncology*Biology*Physics, 21, 137-146.
[28] Falco, M.D., Fontanarosa, D., Miceli, R., Carosi, A., Santoni, R. and D’Andrea, M. (2011) Preliminary Studies for a CBCT Imaging Protocol for Off-Line Organ Motion Analysis: Registration Software Validation and CTDI Measurements. Medical Dosimetry, 36, 91-101.
http://dx.doi.org/10.1016/j.meddos.2010.01.003
[29] Peeters, S.T., Heemsbergen, W.D., van Putten, W.L.J., Scot, A., Tabak, H., Mens, J.W., et al. (2005) Acute and Late Complications after Radiotherapy for Prostate Cancer: Results of a Multicenter Randomized Trial Comparing 68 Gy to 78 Gy. International Journal of Radiation Oncology*Biology*Physics, 61, 1019-1034.
[30] Liu, M., Berthelet, E., Patterson, K., Dick, K. and Kwan, W. (2003) Various Techniques of Contouring the Rectum and Their Impact on Rectal Dose-Volume Histograms. Medical Dosimetry, 28, 189-192. http://dx.doi.org/10.1016/S0958-3947(03)00071-2
[31] Peeters, S.T.H., Hoogeman, M.S., Heemsbergen, W.D., Hart, A.A.M., Koper, P.C.M. and Lebesque, J.V. (2006) Rectal Bleeding, Fecal Incontinence and High Stool Frequency after Conformal Radiotherapy for Prostate Cancer: Normal Tissue Complication Probability Modelling. International Journal of Radiation Oncology Biology Physics, 66, 11-19.
[32] Huang, E.H., Pollack, A., Levy, L., Starkschall, G., Dong, L., Rosen, I., et al. (2002) Late Rectal Toxicity: Dose-Volume Effects of Conformal Radiotherapy for Prostate Cancer. International Journal of Radiation Oncology*Biology* Physics, 54, 1009-1119.
[33] Nuyttens, J.J., Milito, S., Rust, P.F. and Turrisi, A.T. (2002) Dose-Volume Relationship for Acute Side Effects during High Dose Conformal Radiotherapy for Prostate Cancer. Radiotherapy and Oncology, 64, 209-214. http://dx.doi.org/10.1016/S0167-8140(02)00185-8
[34] Marzi, S., Arcangeli, G., Saracino, B., Petrongari, M.G., Bruzzaniti, V., Iaccarino, G., et al. (2007) Relationships between Rectal Wall Dose-Volume Constraints and Radiobiologic Indices of Toxicity for Patients with Prostate Cancer. International Journal of Radiation Oncology*Biology*Physics, 68, 41-49.
[35] Vargas, C., Martinez, A., Kestin, L.L., Yan, D., Grills, I., Brabbins, D.S., et al. (2005) Dose Volume Analysis of Predictors for Chronic Rectal Toxicity after Treatment of Prostate Cancer with Adaptive Image-Guided Radiotherapy. International Journal of Radiation Oncology*Biology*Physics, 62, 1297-1308.
[36] Zelefsky, M.J., Levin, E.J., Hunt, M., Yamada, Y., Shippy, A.M., Jackson, A. and Amols, H.I. (2008) Incidence of Late Rectal and Urinary Toxicities after Three-Dimensional Conformal Radiotherapy and Intensity-Modulated Radiotherapy for Localized Prostate Cancer. International Journal of Radiation Oncology*Biology*Physics, 70, 1124-1129.          eww141016lx
标签：

评论

发表评论

此博客中的热门博文

Does Immigration Promote the Investment of the Monopolistic Firm?

In the present paper, we examine the effect of increasing uncertainty of immigrants’ growth on the optimal timing of investment of a firm that has a monopolistic power over the labor market. It is revealed that when the uncertainty of immigrants’ growth is more than a threshold level, increasing uncertainty of immigrants’ growth accelerates the optimal timing of firms’ investment and enhances the economic growth, even if the uncertainty of immigrants’ growth is formulated by the geometric Brownian motion, which is in sharp contrast to the standard result that an increase in the uncertainty postpones the optimal timing. With an increase in the immigrants over the past ten years, workforces in the host countries have been growing significantly to the extent that the immigrants represent 70% of the increase in the workforce in Europe, and 47% in the United States as OECD indicates. In the present paper, we attempted to investigate the effect of increased uncertainty caused by the growi...
发表评论
阅读全文

Education Policy Implementation: A Mechanism for Enhancing Primary Education Development in Zanzibar

Education is one of the fundamental rights of individuals; therefore, the government of a country needs to develop and strengthen educational policy and quality as well as to ensure that everyone has equal access to basic education. The improvement of access and quality of education in the world is becoming as an essential factor in development, whereas the basic education (primary school), is acknowledged as a foundation of the higher educational development for every country. To fulfill this goal, governments introduce several policies and procedures; however, it requires some reforms and participation from the politician, policymakers, and other stakeholders to re-examine educational policy so that it can lead to multiplication and betterment of the reforms. Educational reforms actually focus on accountability. A positive educational development and reform is very challenging and needs more effort and strategy on how to use and utilize the resources effectively as such it can achie...
发表评论
阅读全文