A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer
Background and purpose: The risk of genitourinary (GU) toxicity is dose-limiting in radiotherapy (RT) for prostate cancer. This study investigated whether motion-inclusive spatial dose/volume metrics explain the GU toxicity manifesting after high-precision RT for prostate cancer. Material and method...
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doaj-fa6e9357d3b94928b8f0f260cbd4cc822020-11-25T00:35:55ZengElsevierPhysics and Imaging in Radiation Oncology2405-63162018-07-0176569A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancerOscar Casares-Magaz0Ludvig P. Muren1Niclas Pettersson2Maria Thor3Austin Hopper4Rick Knopp5Joseph O. Deasy6Michael Væth7John Einck8Vitali Moiseenko9Dept of Medical Physics, Aarhus University Hospital, Aarhus, Denmark; Corresponding author at: Aarhus University Hospital/Aarhus University, Department of Medical Physics, Nørrebrogade 44, Building 5, 8200 Aarhus, Denmark.Dept of Medical Physics, Aarhus University Hospital, Aarhus, DenmarkDept of Medical Physics, Sahlgrenska University Hospital, Gothenburg, SwedenDept of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, USADept of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, USADept of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, USADept of Medical Physics, Memorial Sloan Kettering Cancer Center, New York City, USADept of Public Health, Section for Biostatistics, Aarhus University, Aarhus, DenmarkDept of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, USADept of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, USABackground and purpose: The risk of genitourinary (GU) toxicity is dose-limiting in radiotherapy (RT) for prostate cancer. This study investigated whether motion-inclusive spatial dose/volume metrics explain the GU toxicity manifesting after high-precision RT for prostate cancer. Material and methods: A matched case-control was performed within a cohort of 258 prostate cancer patients treated with daily cone-beam CT (CBCT)-guided RT (prescription doses of 77.4–81.0 Gy). Twenty-seven patients (10.5%) presented late RTOG GU ≥ Grade 2 toxicity and those without symptoms of toxicity prior treatment (N = 7) were selected as cases. Each case was matched with three controls based on pre-treatment GU symptoms, age, Gleason score, follow-up time, and hormone therapy. Thirteen CBCTs per patient were rigidly registered to the planning CT using the recorded treatment shifts, and the bladder was manually contoured on each CBCT. Planned and actually delivered dose/volume metrics (the latter averaged across the CBCTs) were extracted from the bladder and its subsectors, and compared between cases and controls (two-way ANOVA test). Results: There were no significant differences between planned and delivered dose/volume metrics; also, there were no significant differences between cases and controls at any dose level, neither for planned nor delivered doses. The cases tended to have larger bladder volumes during treatment than controls (221 ± 71 cm3 vs 166 ± 73 cm3; p = 0.09). Conclusions: High-precision RT for prostate cancer eliminates differences between planned and delivered dose distributions. Neither planned nor delivered bladder dose/volume metrics were associated to the remaining low risk of developing GU toxicity after high-precision radiotherapy for prostate cancer. Keywords: Prostate cancer, Bladder, Genitourinary toxicity, CBCT, DVH, Spatialhttp://www.sciencedirect.com/science/article/pii/S2405631618300514 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Oscar Casares-Magaz Ludvig P. Muren Niclas Pettersson Maria Thor Austin Hopper Rick Knopp Joseph O. Deasy Michael Væth John Einck Vitali Moiseenko |
spellingShingle |
Oscar Casares-Magaz Ludvig P. Muren Niclas Pettersson Maria Thor Austin Hopper Rick Knopp Joseph O. Deasy Michael Væth John Einck Vitali Moiseenko A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer Physics and Imaging in Radiation Oncology |
author_facet |
Oscar Casares-Magaz Ludvig P. Muren Niclas Pettersson Maria Thor Austin Hopper Rick Knopp Joseph O. Deasy Michael Væth John Einck Vitali Moiseenko |
author_sort |
Oscar Casares-Magaz |
title |
A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer |
title_short |
A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer |
title_full |
A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer |
title_fullStr |
A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer |
title_full_unstemmed |
A case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer |
title_sort |
case-control study using motion-inclusive spatial dose-volume metrics to account for genito-urinary toxicity following high-precision radiotherapy for prostate cancer |
publisher |
Elsevier |
series |
Physics and Imaging in Radiation Oncology |
issn |
2405-6316 |
publishDate |
2018-07-01 |
description |
Background and purpose: The risk of genitourinary (GU) toxicity is dose-limiting in radiotherapy (RT) for prostate cancer. This study investigated whether motion-inclusive spatial dose/volume metrics explain the GU toxicity manifesting after high-precision RT for prostate cancer. Material and methods: A matched case-control was performed within a cohort of 258 prostate cancer patients treated with daily cone-beam CT (CBCT)-guided RT (prescription doses of 77.4–81.0 Gy). Twenty-seven patients (10.5%) presented late RTOG GU ≥ Grade 2 toxicity and those without symptoms of toxicity prior treatment (N = 7) were selected as cases. Each case was matched with three controls based on pre-treatment GU symptoms, age, Gleason score, follow-up time, and hormone therapy. Thirteen CBCTs per patient were rigidly registered to the planning CT using the recorded treatment shifts, and the bladder was manually contoured on each CBCT. Planned and actually delivered dose/volume metrics (the latter averaged across the CBCTs) were extracted from the bladder and its subsectors, and compared between cases and controls (two-way ANOVA test). Results: There were no significant differences between planned and delivered dose/volume metrics; also, there were no significant differences between cases and controls at any dose level, neither for planned nor delivered doses. The cases tended to have larger bladder volumes during treatment than controls (221 ± 71 cm3 vs 166 ± 73 cm3; p = 0.09). Conclusions: High-precision RT for prostate cancer eliminates differences between planned and delivered dose distributions. Neither planned nor delivered bladder dose/volume metrics were associated to the remaining low risk of developing GU toxicity after high-precision radiotherapy for prostate cancer. Keywords: Prostate cancer, Bladder, Genitourinary toxicity, CBCT, DVH, Spatial |
url |
http://www.sciencedirect.com/science/article/pii/S2405631618300514 |
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