Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer
Purpose: To investigate estimated delivered dose distributions using weekly cone-beam computed tomography (CBCT) scans for pelvic organs at risk (OARs) in salvage radiotherapy (SRT) after radical prostatectomy. Furthermore, to compare them with the originally planned dose distributions and analyse a...
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| Format: | Article |
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Elsevier
2024-03-01
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| Series: | Technical Innovations & Patient Support in Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405632423000318 |
| _version_ | 1827318600132722688 |
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| author | Vilberg Jóhannesson Adalsteinn Gunnlaugsson Per Nilsson Patrik Brynolfsson Elisabeth Kjellén Elinore Wieslander |
| author_facet | Vilberg Jóhannesson Adalsteinn Gunnlaugsson Per Nilsson Patrik Brynolfsson Elisabeth Kjellén Elinore Wieslander |
| author_sort | Vilberg Jóhannesson |
| collection | DOAJ |
| description | Purpose: To investigate estimated delivered dose distributions using weekly cone-beam computed tomography (CBCT) scans for pelvic organs at risk (OARs) in salvage radiotherapy (SRT) after radical prostatectomy. Furthermore, to compare them with the originally planned dose distributions and analyse associations with gastrointestinal (GI) and genitourinary (GU) side effects. Methods: This study is part of a phase II trial involving SRT for recurrent prostate cancer. Treatment was personalised based on PSA response during SRT, classifying patients as PSA responders or non-responders. Estimated radiation dose distributions were obtained using deformable image registration from weekly CBCT scans. GI and GU toxicities were assessed using the RTOG toxicity scale, while patient-reported symptoms were monitored through self-assessment questionnaires. Results: The study included 100 patients, with similar treatment-related side effects observed in both responders and non-responders. Differences in dose-volume metrics between the planned and estimated delivered doses for the examined OARs were mostly modest, although generally statistically significant. We identified statistically significant associations between QUANTEC-recommended dose-volume constraints and acute bowel toxicity, as well as late urinary patient-reported symptoms, for both the estimated delivered and planned dose distributions. Conclusion: We found small but statistically significant differences between estimated delivered and planned doses to OARs. These differences showed trends toward improved associations for estimated delivered dose distributions with side effects. Enhanced registration methods and imaging techniques could potentially further enhance the assessment of truly delivered doses and yield more reliable dose-volume constraints for future therapies. |
| first_indexed | 2024-03-08T21:29:12Z |
| format | Article |
| id | doaj.art-6efe546acac8495b9e25213429339a4d |
| institution | Directory Open Access Journal |
| issn | 2405-6324 |
| language | English |
| last_indexed | 2024-04-25T00:03:44Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Technical Innovations & Patient Support in Radiation Oncology |
| spelling | doaj.art-6efe546acac8495b9e25213429339a4d2024-03-14T06:15:11ZengElsevierTechnical Innovations & Patient Support in Radiation Oncology2405-63242024-03-0129100231Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancerVilberg Jóhannesson0Adalsteinn Gunnlaugsson1Per Nilsson2Patrik Brynolfsson3Elisabeth Kjellén4Elinore Wieslander5Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Lund, Sweden; Corresponding author at: Vilberg Jóhannesson, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Klinikgatan 5, 22185 Lund, Sweden.Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Lund, SwedenRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Radiation Physics, Lund, SwedenRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, SwedenDepartment of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Oncology and Pathology, Lund, SwedenRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, SwedenPurpose: To investigate estimated delivered dose distributions using weekly cone-beam computed tomography (CBCT) scans for pelvic organs at risk (OARs) in salvage radiotherapy (SRT) after radical prostatectomy. Furthermore, to compare them with the originally planned dose distributions and analyse associations with gastrointestinal (GI) and genitourinary (GU) side effects. Methods: This study is part of a phase II trial involving SRT for recurrent prostate cancer. Treatment was personalised based on PSA response during SRT, classifying patients as PSA responders or non-responders. Estimated radiation dose distributions were obtained using deformable image registration from weekly CBCT scans. GI and GU toxicities were assessed using the RTOG toxicity scale, while patient-reported symptoms were monitored through self-assessment questionnaires. Results: The study included 100 patients, with similar treatment-related side effects observed in both responders and non-responders. Differences in dose-volume metrics between the planned and estimated delivered doses for the examined OARs were mostly modest, although generally statistically significant. We identified statistically significant associations between QUANTEC-recommended dose-volume constraints and acute bowel toxicity, as well as late urinary patient-reported symptoms, for both the estimated delivered and planned dose distributions. Conclusion: We found small but statistically significant differences between estimated delivered and planned doses to OARs. These differences showed trends toward improved associations for estimated delivered dose distributions with side effects. Enhanced registration methods and imaging techniques could potentially further enhance the assessment of truly delivered doses and yield more reliable dose-volume constraints for future therapies.http://www.sciencedirect.com/science/article/pii/S2405632423000318Organs at riskProstate cancerVolumetric-modulated arc therapyEstimated delivered doseSalvage radiotherapy |
| spellingShingle | Vilberg Jóhannesson Adalsteinn Gunnlaugsson Per Nilsson Patrik Brynolfsson Elisabeth Kjellén Elinore Wieslander Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer Technical Innovations & Patient Support in Radiation Oncology Organs at risk Prostate cancer Volumetric-modulated arc therapy Estimated delivered dose Salvage radiotherapy |
| title | Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer |
| title_full | Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer |
| title_fullStr | Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer |
| title_full_unstemmed | Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer |
| title_short | Dose-volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer |
| title_sort | dose volume relationships of planned versus estimated delivered radiation doses to pelvic organs at risk and side effects in patients treated with salvage radiotherapy for recurrent prostate cancer |
| topic | Organs at risk Prostate cancer Volumetric-modulated arc therapy Estimated delivered dose Salvage radiotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2405632423000318 |
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