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Prostate Volume Changes during Extreme and Moderately Hypofractionated Magnetic Resonance Image-guided Radiotherapy.

S E Alexander¹, H A McNair¹, U Oelfke²

¹The Royal Marsden NHS Foundation Trust, Sutton, UK; The Institute of Cancer Research, London, UK.

Clinical Oncology (Royal College of Radiologists (Great Britain))

|April 26, 2022

Summary

This summary is machine-generated.

Prostate cancer patients undergoing radiotherapy experience significant volume and dimension changes, especially with extreme hypofractionation. Magnetic resonance image-guided radiotherapy (MRIgRT) can quantify these prostate deformations.

Keywords:

Hypofractionated radiotherapy MRI MRIgRT prostate cancer swelling volume change

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Area of Science:

Radiation Oncology
Medical Imaging
Prostate Cancer Treatment

Background:

Prostate morphological changes during external beam radiotherapy are not well understood.
Magnetic resonance image-guided radiotherapy (MRIgRT) offers superior soft-tissue visualization for studying these changes.

Purpose of the Study:

To quantify prostate volume and dimension changes during extreme and moderately hypofractionated radiotherapy schedules.

Main Methods:

Retrospective review of 40 prostate cancer patients treated on a 1.5T MRI linear accelerator (MRL).
Patients received either 36.25 Gy in 5 fractions (extreme hypofractionation) or 60 Gy in 20 fractions (moderate hypofractionation).
Prostate volumes and dimensions were measured using CT and daily MRL T2-weighted images.

Main Results:

Significant prostate volume increases were observed in both groups, with greater changes in the extreme hypofractionation group (peak 21% increase).
Prostate expansion was most pronounced in the superior-inferior direction (peak 5.9 mm in extreme hypofractionation).
Significant volume changes occurred throughout treatment in both schedules.

Conclusions:

Significant prostate volume and dimension changes occur during hypofractionated radiotherapy.
These changes are more pronounced with extreme hypofractionation.
MRIgRT is valuable for quantifying and potentially correcting treatment-related prostate deformation.