Document Detail


Adaptive radiotherapy for long course neo-adjuvant treatment of rectal cancer.
MedLine Citation:
PMID:  22444244     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To quantify the potential margin reduction with adaptive radiotherapy (ART) during neo-adjuvant treatment of locally-advanced rectal cancer. METHODS AND MATERIALS: Repeat CT scans were acquired for 28 patients treated with 25×2Gy, daily during the first week, and followed by weekly scans. The CTV was delineated on all scans, and shape variation was estimated. Five ART strategies were tested, consisting of an average CTV over the planning CT and one to five repeat CTs. Required PTV margins were calculated for adapted and non-adapted treatment. The strategy with the least PTV volume over the whole treatment was selected and bowel area dose reduction was estimated. RESULTS: Substantial systematic and random shape variation demanded for a PTV margin up to 2.4cm at the upper-anterior part of the CTV. Plan adaptation after fraction 4 resulted in a maximum 0.7cm margin reduction and a significant PTV reduction from 1185 to 1023cc (p<0.0001). The bowel area volume receiving 15, 45, and 50Gy was reduced from 436 to 402cc, 111 to 81cc, and 49 to 29cc, respectively (p<0.0001). CONCLUSIONS: With adaptive radiotherapy, maximum required PTV margins can be reduced from 2.4 to 1.7cm, resulting in significantly less dose to the bowel area.
Authors:
Jasper Nijkamp; Corrie Marijnen; Marcel van Herk; Baukelien van Triest; Jan-Jakob Sonke
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-21
Journal Detail:
Title:  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology     Volume:  -     ISSN:  1879-0887     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407192     Medline TA:  Radiother Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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