Application of a spacer gel to optimize three-dimensional conformal and intensity modulated radiotherapy for prostate cancer
Application of a spacer gel to optimize three-dimensional conformal and intensity modulated radiotherapy for prostate cancer
复制标题
DOI：
10.1016/j.radonc.2011.09.005
复制
发表时间：
2011-09-01
影响因子：
5.7
通讯作者：
Eble, Michael J.
中科院分区：
文献类型：
--
作者：
Pinkawa, Michael;Corral, Nuria Escobar;Eble, Michael J.
背景和目的：目的是评估间隔凝胶对剂量分布的影响，应用三维适形（3D CRT）和调强放射治疗（IMRT）规划techniques.Material and methods：间隔凝胶（10 ml SpaceOAR（TM））的注射在18例前列腺癌患者经直肠超声引导下进行前列腺和直肠之间。结果：与PTV和膀胱相比，两种技术的前、后间隔器计划在直肠剂量分析值方面均具有显著优势（p < 0.01）。无论采用何种技术，直肠NTCP（正常组织并发症概率）在间隔器注射后均达到最低百分比，IMRT和3D CRT的平均减少>50%。IMRT计划与3D CRT计划相比，PTV的D（平均值）和V（78）显著（p < 0.01）更高，直肠V（76）更小，但直肠V（50）更大。结论：在前列腺和直肠前壁之间注射间隔凝胶与直肠剂量显著降低相关，因此NTCP值更低，与放射治疗技术无关。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学100（2011）436-441
Background and purpose: The aim was to evaluate the impact of a spacer gel on the dose distribution, applying three-dimensional conformal (3D CRT) and intensity modulated radiotherapy (IMRT) planning techniques.Material and methods: The injection of a spacer gel (10 ml SpaceOAR (TM)) was performed between the prostate and rectum under transrectal ultrasound guidance in 18 patients with prostate cancer. 3D CRT and IMRT treatment plans were compared based on CT before and after injection (78 Gy prescription dose).Results: In contrast to the PTV and bladder, significant advantages (p < 0.01) resulted in respect of all analysed rectal dose values comparing pre spacer with post spacer plans for both techniques. Rectal NTCP (normal tissue complication probability) reached the lowest percentage after spacer injection irrespective of the technique, with a mean reduction of >50% for both IMRT and 3D CRT. Significantly (p < 0.01) higher D(mean), and V(78) for the PTV were reached with IMRT vs. 3D CRT plans, with a smaller rectum V(76) but larger rectum V(50).Conclusions: The injection of a spacer gel between the prostate and anterior rectal wall is associated with considerably lower doses to the rectum and consequentially lower NTCP values irrespective of the radiotherapy technique. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 436-441