| The effect of uterine motion and uterine margins on target and normal tissue doses in intensity modulated radiation therapy of cervical cancer. | |
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MedLine Citation:
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PMID: 21490387 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In intensity modulated radiation therapy (IMRT) of cervical cancer, uterine motion can be larger than cervix motion, requiring a larger clinical target volume to planning target volume (CTV-to-PTV) margin around the uterine fundus. This work simulates different motion models and margins to estimate the dosimetric consequences. A virtual study used image sets from ten patients. Plans were created with uniform margins of 1 cm (PTV(A)) and 2.4 cm (PTV(C)), and a margin tapering from 2.4 cm at the fundus to 1 cm at the cervix (PTV(B)). Three inter-fraction motion models (MM) were simulated. In MM1, all structures moved with normally distributed rigid body translations. In MM2, CTV motion was progressively magnified as one moved superiorly from the cervix to the fundus. In MM3, both CTV and normal tissue motion were magnified as in MM2, modeling the scenario where normal tissues move into the void left by the mobile uterus. Plans were evaluated using static and percentile DVHs. For a conventional margin (PTV(A)), quasi-realistic uterine motion (MM3) reduces fundus dose by about 5 Gy and increases normal tissue volumes receiving 30-50 Gy by ∼5%. A tapered CTV-to-PTV margin can restore fundus and CTV doses, but will increase normal tissue volumes receiving 30-50 Gy by a further ∼5%. |
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Authors:
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J J Gordon; E Weiss; O K Abayomi; J V Siebers; N Dogan |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2011-04-13 |
Journal Detail:
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Title: Physics in medicine and biology Volume: 56 ISSN: 1361-6560 ISO Abbreviation: Phys Med Biol Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-27 Completed Date: 2011-08-15 Revised Date: 2012-05-24 |
Medline Journal Info:
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Nlm Unique ID: 0401220 Medline TA: Phys Med Biol Country: England |
Other Details:
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Languages: eng Pagination: 2887-901 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, Virginia Commonwealth University, PO Box 980058, Richmond, VA 23298, USA. jjgordon@vcu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Dose Fractionation Female Humans Magnetic Resonance Imaging Movement* Organs at Risk / radiation effects* Patient Positioning Radiation Dosage* Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted Radiotherapy, Intensity-Modulated / methods* Stochastic Processes Uncertainty Uterine Cervical Neoplasms / diagnosis, physiopathology*, radiotherapy* Uterus* / physiopathology, radiation effects |
| Grant Support | |
ID/Acronym/Agency:
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P01 CA116602-01A2/CA/NCI NIH HHS; P01CA116602/CA/NCI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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