Prostatic displacement during extreme hypofractionated radiotherapy using volumetric modulated arc therapy (VMAT)

Radiation Oncology

Andrew Loblaw¹  Andrea Deabreu²  Laura D’Alimonte²  Patrick Cheung²  Geordi Pang²  Adam Gladwish³ 

[1] Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Rm T2-103, Toronto M4N 3 M5, Ontario, Canada;Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada;Department of Radiation Oncology, University of Toronto, Toronto, Canada

关键词: Intra-fraction motion;    Prostate neoplasms;    Image-guided radiation therapy;   

Others  :  1150858
DOI  :  10.1186/s13014-014-0262-y

 received in 2013-11-22, accepted in 2014-11-14,  发布年份 2014

【 摘 要 】

Background

To determine prostate displacement during extreme hypofractionated volume modulated arc radiotherapy (VMAT) using pre- and post-treatment orthogonal images with three implanted gold seed fiducial markers.

Methods

A total of 150 image pairs were obtained from 30 patients who underwent extreme hypofractionated radiotherapy to a dose of 40 Gy in five fractions on standard linear accelerators. Position verification was obtained with orthogonal x-rays before and after treatment and were used to determine intra-fraction prostate displacement.

Results

The mean prostate displacements were 0.03 ± 1.23 mm (1SD), 0.18 ± 1.55 mm, and 0.37 ± 1.95 mm in the left-right, superior-inferior, and anterior-posterior directions, respectively. The mean 3D displacement was 2.32 ± 1.55 mm. Only 6 (4%) fractions had a 3D displacement of >5 mm. The average time of treatment delivery for a given fraction was 195 ± 59 seconds.

Conclusions

The mean intra-fraction prostate displacement during a course of extreme hypofractionated radiotherapy delivered via VMAT, continues to be small. Clinical margins typically used in a similar fixed-angle IMRT treatment are adequate. The use of VMAT in further extreme hypofractionation may limit prostatic motion uncertainties that would be otherwise be associated with longer treatment times.

【 授权许可】

   
2014 Gladwish et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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