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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Published on: February 6, 2019

Adaptive off-line protocol for prostate external radiotherapy with cone beam computer tomography.

M Piziorska¹, P Kukołowicz, A Zawadzka

¹Medical Physics Department, Center of Oncology, Warsaw, Poland.

Strahlentherapie Und Onkologie : Organ Der Deutschen Rontgengesellschaft ... [Et Al]

|October 12, 2012

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This study developed an adaptive protocol for prostate radiotherapy using kilovoltage cone beam computed tomography (CBCT). The protocol effectively minimizes setup errors, allowing for reduced planning target volume margins in prostate cancer treatment.

Area of Science:

Radiotherapy and Oncology
Medical Imaging
Radiation Physics

Background:

Image-guided radiotherapy (IGRT) is crucial for precise cancer treatment.
Prostate cancer treatment requires accurate targeting to minimize dose to organs at risk.
Kilovoltage cone beam computed tomography (CBCT) offers in-room imaging for IGRT.

Purpose of the Study:

To develop and evaluate an off-line adaptive protocol for prostate teleradiotherapy.
To assess the efficacy of kilovoltage cone beam computed tomography (CBCT) in an adaptive workflow.
To determine if the adaptive protocol can reduce margins in prostate radiotherapy.

Main Methods:

An off-line adaptive protocol was designed using CBCT data from 10 patients.
Prostate and pubis symphysis positions were measured relative to the isocenter.

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The protocol involved calculating average prostate position and correcting for displacements exceeding 0.2 cm.

Main Results:

Prostate displacement greater than 0.7 cm vertically/longitudinally occurred in only 4-5 out of 162 CBCT images for the initial 10 patients.
In a larger group of 30 patients, displacements exceeding 0.7 cm vertically or 0.3 cm laterally were not observed.
Longitudinal displacements exceeded 0.7 cm in two cases within the 30-patient cohort.

Conclusions:

The proposed adaptive protocol effectively reduces systematic internal errors in prostate radiotherapy.
Implementation of this protocol allows for a significant reduction in the clinical target volume (CTV) to planning target volume (PTV) margin.
Reduced margins were achieved: 0.7 cm (vertical), 0.7 cm (longitudinal), and 0.4 cm (lateral).