Guckenberger, Matthias and Pohl, Fabian and Baier, Kurt and Meyer, Juergen and Vordermark, Dirk and Flentje, Michael (2006) Adverse effect of a distended rectum in intensity-modulated radiotherapy (IMRT) treatment planning of prostate cancer. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 79 (1), pp. 59-64.
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BACKGROUND AND PURPOSE: The retrospective planning study for intensity-modulated radiotherapy (IMRT) of prostate cancer evaluated whether proximal rectum and supra-anal rectum/anal canal should be delineated as separated organs-at-risk (OARs) to achieve optimal dose distributions to the anorectal region. PATIENTS AND METHODS: For 10 patients with localized prostate cancer IMRT plans were generated with the rectum and anal canal as separated OARs (Rec-sep) and as one single OAR (Rec-tot). Two different treatment planning systems (TPS) were utilized. Influence on dose distributions to target and OARs was analyzed. RESULTS: Results from both TPS showed significantly increased doses to the distal rectum/anal canal for plans Rec-tot compared with Rec-sep in case of a distended rectum in the planning CT study: doses were increased by up to mean 31% (P = 0.02) and 18% (P = 0.03), respectively, in both TPS. For the patient with the largest rectum, the maximum dose increase was 61%. No significant differences in doses to target, bladder, femoral head and proximal rectum were seen. CONCLUSIONS: For patients with a distended rectum in the planning CT, delineation of separated OARs for proximal rectum and distal rectum/anal canal resulted in superior dose distributions to the anorectal region and therefore, we recommend this as standard procedure for IMRT planning of prostate cancer.
|Institutions:||Medicine > Lehrstuhl für Strahlentherapie|
|Keywords:||Prostate cancer; Rectal distension; Toxicity; Planning study; Anal canal|
|Subjects:||600 Technology > 610 Medical sciences Medicine|
|Refereed:||Yes, this version has been refereed|
|Created at the University of Regensburg:||Unknown|
|Deposited On:||30 Aug 2007|
|Last Modified:||20 Jul 2011 21:06|