Document Detail


Dose-distance metric that predicts late rectal bleeding in patients receiving radical prostate external-beam radiotherapy.
MedLine Citation:
PMID:  23190583     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The relationship between rectal dose distribution and the incidence of late rectal complications following external-beam radiotherapy has been previously studied using dose-volume histograms or dose-surface histograms. However, they do not account for the spatial dose distribution. This study proposes a metric based on both surface dose and distance that can predict the incidence of rectal bleeding in prostate cancer patients treated with radical radiotherapy. One hundred and forty-four patients treated with radical radiotherapy for prostate cancer were prospectively followed to record the incidence of grade ≥2 rectal bleeding. Radiotherapy plans were used to evaluate a dose-distance metric that accounts for the dose and its spatial distribution on the rectal surface, characterized by a logistic weighting function with slope a and inflection point d(0). This was compared to the effective dose obtained from dose-surface histograms, characterized by the parameter n which describes sensitivity to hot spots. The log-rank test was used to determine statistically significant (p < 0.05) cut-off values for the dose-distance metric and effective dose that predict for the occurrence of rectal bleeding. For the dose-distance metric, only d(0) = 25 and 30 mm combined with a > 5 led to statistical significant cut-offs. For the effective dose metric, only values of n in the range 0.07-0.35 led to statistically significant cut-offs. The proposed dose-distance metric is a predictor of rectal bleeding in prostate cancer patients treated with radiotherapy. Both the dose-distance metric and the effective dose metric indicate that the incidence of grade ≥2 rectal bleeding is sensitive to localized damage to the rectal surface.
Authors:
Richard Lee; Elisa K Chan; Robert Kosztyla; Mitchell Liu; Vitali Moiseenko
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  Physics in medicine and biology     Volume:  57     ISSN:  1361-6560     ISO Abbreviation:  Phys Med Biol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401220     Medline TA:  Phys Med Biol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  8297-8307     Citation Subset:  -    
Affiliation:
Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Centre, 600 West 10th Ave, Vancouver, BC V5Z 4E6, Canada.
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