PMID- 21470786
OWN - NLM
STAT- MEDLINE
DCOM- 20120511
LR  - 20220409
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 82
IP  - 5
DP  - 2012 Apr 1
TI  - Practical method of adaptive radiotherapy for prostate cancer using real-time 
      electromagnetic tracking.
PG  - 1903-11
LID - 10.1016/j.ijrobp.2011.01.040 [doi]
AB  - PURPOSE: We have created an automated process using real-time tracking data to 
      evaluate the adequacy of planning target volume (PTV) margins in prostate cancer, 
      allowing a process of adaptive radiotherapy with minimal physician workload. We 
      present an analysis of PTV adequacy and a proposed adaptive process. METHODS AND 
      MATERIALS: Tracking data were analyzed for 15 patients who underwent 
      step-and-shoot multi-leaf collimation (SMLC) intensity-modulated radiation 
      therapy (IMRT) with uniform 5-mm PTV margins for prostate cancer using the 
      Calypso(R) Localization System. Additional plans were generated with 0- and 3-mm 
      margins. A custom software application using the planned dose distribution and 
      structure location from computed tomography (CT) simulation was developed to 
      evaluate the dosimetric impact to the target due to motion. The dose delivered to 
      the prostate was calculated for the initial three, five, and 10 fractions, and 
      for the entire treatment. Treatment was accepted as adequate if the minimum 
      delivered prostate dose (D(min)) was at least 98% of the planned D(min). RESULTS: 
      For 0-, 3-, and 5-mm PTV margins, adequate treatment was obtained in 3 of 15, 12 
      of 15, and 15 of 15 patients, and the delivered D(min) ranged from 78% to 99%, 
      96% to 100%, and 99% to 100% of the planned D(min). Changes in D(min) did not 
      correlate with magnitude of prostate motion. Treatment adequacy during the first 
      10 fractions predicted sufficient dose delivery for the entire treatment for all 
      patients and margins. CONCLUSIONS: Our adaptive process successfully used 
      real-time tracking data to predict the need for PTV modifications, without the 
      added burden of physician contouring and image analysis. Our methods are 
      applicable to other uses of real-time tracking, including hypofractionated 
      treatment.
CI  - Copyright A(c) 2012 Elsevier Inc. All rights reserved.
FAU - Olsen, Jeffrey R
AU  - Olsen JR
AD  - Department of Radiation Oncology, Washington University School of Medicine, St. 
      Louis, MO, USA.
FAU - Noel, Camille E
AU  - Noel CE
FAU - Baker, Kenneth
AU  - Baker K
FAU - Santanam, Lakshmi
AU  - Santanam L
FAU - Michalski, Jeff M
AU  - Michalski JM
FAU - Parikh, Parag J
AU  - Parikh PJ
LA  - eng
GR  - R01 CA134541/CA/NCI NIH HHS/United States
GR  - R01 CA134541-03/CA/NCI NIH HHS/United States
GR  - R01CA134541/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20110404
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Computer Systems
MH  - Dose Fractionation, Radiation
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Movement
MH  - Organs at Risk/radiation effects
MH  - Prostate/pathology
MH  - Prostatic Neoplasms/pathology/*radiotherapy
MH  - Radiotherapy Planning, Computer-Assisted/*methods
MH  - Radiotherapy, Image-Guided/*methods
MH  - Radiotherapy, Intensity-Modulated/*methods
MH  - Rectum/anatomy & histology/radiation effects
MH  - Rotation
MH  - Software
MH  - Tomography, X-Ray Computed/*methods
MH  - Tumor Burden
PMC - PMC3132289
MID - NIHMS279987
COIS- Conflict of Interest Notification: Research interface provided by Calypso Medical 
      Technologies. Dr. Parikh receives research funding from Calypso Medical 
      Technologies. Supported in part by NCI R01CA134541.
EDAT- 2011/04/08 06:00
MHDA- 2012/05/12 06:00
PMCR- 2013/04/01
CRDT- 2011/04/08 06:00
PHST- 2009/12/14 00:00 [received]
PHST- 2011/01/11 00:00 [revised]
PHST- 2011/01/26 00:00 [accepted]
PHST- 2011/04/08 06:00 [entrez]
PHST- 2011/04/08 06:00 [pubmed]
PHST- 2012/05/12 06:00 [medline]
PHST- 2013/04/01 00:00 [pmc-release]
AID - S0360-3016(11)00208-2 [pii]
AID - 10.1016/j.ijrobp.2011.01.040 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):1903-11. doi: 
      10.1016/j.ijrobp.2011.01.040. Epub 2011 Apr 4.