Jm. Balter et al., ONLINE REPOSITIONING DURING TREATMENT OF THE PROSTATE - A STUDY OF POTENTIAL LIMITS AND GAINS, International journal of radiation oncology, biology, physics, 27(1), 1993, pp. 137-143
Citations number
11
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: With on-line portal imaging devices and image registration to
ols, the verification of radiation field position Prior to each treatm
ent becomes technically feasible. In this paper, we analyze the impact
of pre-treatment verification and field position adjustment on target
coverage and normal tissue sparing. Methods and Materials: Port films
were compared with corresponding simulation films to determine the ma
gnitude of setup variations in patients treated for prostate cancer. F
rom these data, an analytic function was determined between geometric
coverage of the target and field margin size. A paradigm for on-line p
atient repositioning was employed to generate a new relationship betwe
en margin and target coverage. Margins were selected for the situation
s of normal treatment and on-line repositioning to ensure target cover
age. Dose-volume histograms were generated for a typical prostate trea
tment using these margins. Results: On-line repositioning, when setup
errors exceed 1 cm, results in a 6 mm reduction in margin, suggesting
that 10% of the volume of bladder and rectum may be spared of high dos
e. Conclusion: The use of on-line imaging and image registration to gu
ide adjustment of patient setup may lead to a eduction in the volume o
f normal tissues irradiated, and possibly improve the probability of c
omplication-free survival in future treatments.