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Fractionated changes in prostate cancer radiotherapy using cone-beam computed tomography
Tzung-Chi Huang1, Kuei-Ting Chou2, Shih-Neng Yang1
1Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung City, Taiwan; Department of Biomedical Informatics, Asia University, Taichung City, Taiwan.
Radiation therapy for prostate cancer can be uncertain due to bladder and rectum movement. Daily imaging revealed significant differences in radiation doses delivered compared to treatment plans.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Prostate Cancer Treatment
Background:
- High mobility of the bladder and rectum introduces uncertainty in radiation doses for prostate cancer patients undergoing multifraction radiotherapy.
- Accurate dose delivery is crucial for effective treatment and minimizing side effects.
Purpose of the Study:
- To estimate the actual radiation dose received by the bladder, rectum, and prostate during multifraction treatments.
- To assess the impact of organ motion on dose distribution using daily cone-beam computed tomography (CBCT).
Main Methods:
- Enrolled 28 prostate cancer patients undergoing radiotherapy.
- Utilized daily CBCT registered with planning CT to map dose distribution.
- Estimated received radiation doses and organ volumes during clinical treatment.
Main Results:
- Observed substantial mean differences in volume (44% bladder, 36% rectum) and radiation dose (18% bladder, 22% rectum) compared to treatment plans.
- Prostate showed smaller variations (20% volume, 2% dose).
- Significant discrepancies highlight the impact of organ motion on delivered radiation dose.
Conclusions:
- Daily CBCT imaging is valuable for assessing dose variations in prostate cancer radiotherapy.
- Significant changes in bladder and rectum volumes necessitate adjustments beyond standard image-guided radiotherapy.
- Consideration of these volume changes is crucial for optimizing radiation dose delivery in external beam radiation for prostate cancer.
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