PMID- 32888359
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1526-9914 (Electronic)
IS  - 1526-9914 (Linking)
VI  - 21
IP  - 10
DP  - 2020 Oct
TI  - Stability of daily rectal movement and effectiveness of replanning protocols for 
      sparing rectal doses based on the daily CT images during proton treatment for 
      prostate cancer.
PG  - 109-121
LID - 10.1002/acm2.13015 [doi]
AB  - PURPOSE: To evaluate the optimal period of replanning to spare the rectal dose by 
      investigating daily rectal movements during computed tomography (CT) image-guided 
      proton therapy for prostate cancer. MATERIALS AND METHODS: To evaluate the 
      optimum reference period for replanning, we analyzed 1483 sets of daily CT (dCT) 
      images acquired from 40 prostate cancer patients and measured the daily rectal 
      movement along the anterior-posterior direction based on the simulator CT (sCT) 
      images and dCT images. We calculated daily dose distributions based on initial 
      plans on the sCT images and replans on the dCT images for 13 representative 
      patients, and evaluated daily dose volume histograms (DVHs) for the prostate, 
      seminal vesicles, and rectum. RESULTS: The rectal anterior side on the dCT images 
      around the seminal vesicles largely deviated toward the anterior side relative to 
      the position on the reference sCT images, but the deviation decreased by 
      referring to the dCT images and became nearly zero when we referred to the dCT 
      images after 10-day treatment. The daily DVH values for the prostate showed good 
      dose coverage. For six patients showing rectal movement toward the anterior side, 
      the daily rectal DVH (V(77%) ) showed a 3.0 +/- 1.7 cc excess from the initial plan 
      and this excess was correlated with 9.9 +/- 6.8 mm rectal movement. To identify the 
      patients (37.5% in total) for whom the replanning on the 10th-day and 20th-day CT 
      images reduced the V(77%) excess to 0.4 +/- 1.5 cc and -0.2 +/- 1.3 cc, respectively, 
      we evaluated the accumulated mean doses with a 1.2 cc criterion. CONCLUSION: Our 
      data demonstrate that the daily movement of the rectal anterior side tends to 
      move toward the anterior side, which results in a rectal overdose, and the mean 
      of the movement gradually decreases with the passage of days. In such cases, 
      replanning with the reference CT after 10 days is effective to spare the rectal 
      dose.
CI  - (c) 2020 The Authors. Journal of Applied Clinical Medical Physics published by 
      Wiley Periodicals LLC on behalf of American Association of Physicists in 
      Medicine.
FAU - Maeda, Yoshikazu
AU  - Maeda Y
AUID- ORCID: 0000-0002-3040-5549
AD  - Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan.
FAU - Sato, Yoshitaka
AU  - Sato Y
AD  - Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan.
FAU - Yamamoto, Kazutaka
AU  - Yamamoto K
AD  - Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan.
FAU - Tamamura, Hiroyasu
AU  - Tamamura H
AD  - Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan.
FAU - Sasaki, Makoto
AU  - Sasaki M
AD  - Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan.
FAU - Fuwa, Nobukazu
AU  - Fuwa N
AD  - Department of Radiotherapy, Ise Red Cross Hospital, Ise, Mie, Japan.
FAU - Takamatsu, Shigeyuki
AU  - Takamatsu S
AD  - Department of Radiation Therapy, Kanazawa University Hospital, Kanazawa, 
      Ishikawa, Japan.
FAU - Kume, Kyo
AU  - Kume K
AD  - Research & Development Department, The Wakasa Wan Energy Research Center, 
      Tsuruga, Fukui, Japan.
LA  - eng
GR  - JP17K09079/Japan Society for the Promotion of Science/
PT  - Journal Article
DEP - 20200905
PL  - United States
TA  - J Appl Clin Med Phys
JT  - Journal of applied clinical medical physics
JID - 101089176
RN  - 0 (Protons)
SB  - IM
MH  - Humans
MH  - Male
MH  - Movement
MH  - *Prostatic Neoplasms/diagnostic imaging/radiotherapy
MH  - *Protons
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted
MH  - Rectum/diagnostic imaging
MH  - Tomography, X-Ray Computed
PMC - PMC7592984
OTO - NOTNLM
OT  - adaptive radiotherapy
OT  - image-guided radiotherapy
OT  - in-room CT image guidance
OT  - prostate cancer
OT  - proton therapy
COIS- None of the authors have any financial interest or personal relationships with 
      other persons or organizations that could inappropriately influence our work.
EDAT- 2020/09/06 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/09/05
CRDT- 2020/09/05 08:33
PHST- 2020/03/17 00:00 [received]
PHST- 2020/05/04 00:00 [revised]
PHST- 2020/07/29 00:00 [accepted]
PHST- 2020/09/06 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/09/05 08:33 [entrez]
PHST- 2020/09/05 00:00 [pmc-release]
AID - ACM213015 [pii]
AID - 10.1002/acm2.13015 [doi]
PST - ppublish
SO  - J Appl Clin Med Phys. 2020 Oct;21(10):109-121. doi: 10.1002/acm2.13015. Epub 2020 
      Sep 5.