OVREDNOTENJE INTRAFRAKCIJSKIH PREMIKOV PRI RADIKALNEM OBSEVANJU KARCINOMA PROSTATE.
Introduction: The evaluation of intrafraction motion of prostate cancer during the radiation therapy process, which includes monitoring of the movement of the patient and of the internal organs, is a common process in clinical practice and has a significant impact on determining the size of the heal...
| Publicado en: | Bulletin: Newsletter of the Society of Radiographers of Slovenia & the Chamber of Radiographers of Slovenia Vol. 33; no. 1; pp. 4 - 10 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Slovenian Society of Radiographers
2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=119266770&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 119266770 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07185551 95H6 jtl: Bulletin: Newsletter of the Society of Radiographers of Slovenia & the Chamber of Radiographers of Slovenia issn: 07185551 maglogo: N pubinfo: dt: 2016 vid: 33 iid: 1 pid: 56331 pub: Slovenian Society of Radiographers artinfo: ui: 119266770 119266770 119266770 119266770 ppf: 4 ppct: 6 formats: fmt: @attributes: type: P tig: atl: OVREDNOTENJE INTRAFRAKCIJSKIH PREMIKOV PRI RADIKALNEM OBSEVANJU KARCINOMA PROSTATE. aug: au: Breznik, Andrej Kragelj, Borut Peterlin, Primož Marciuš, Valerija Žager Oblak, Irena affil: Onkološki inštitut Ljubljana, Sektor radioterapije, Oddelek za teleradioterapijo, Zaloška cesta 2,1000 Ljubljana sug: ab: Introduction: The evaluation of intrafraction motion of prostate cancer during the radiation therapy process, which includes monitoring of the movement of the patient and of the internal organs, is a common process in clinical practice and has a significant impact on determining the size of the healthy margins. Purpose: The purpose of the study was to improve the quality of therapy in the radical radiotherapy of prostate cancer by calculating the appropriate size of the healthy margins according to the Van Herk formula. Methods: The study included 9 patients with prostate cancer who received volumetric modulated radiation therapy (VMAT) in the combination with the on-line image guided radiotherapy (IGRT). Three intraprostatic gold fiducial markers were inserted in the prostate by ultrasound before the radiotherapy, in order to allow localisation of the prostate on the electronic portal imaging device (EPID). Systematic population error (Σ) and random population error (σ) of movements were based on daily pre- and post-treatment images. Clinical target volume (CTV) and planning target volume (PTV), the healthy margins were calculated according to Van Herk formula. Results and discussion: The average movements and standard deviations of intrafraction prostate movements were (mean ± SD): –0.11 ± 1.79 mm, –1.07 ± 1.65 m and –0.65 ± 1.56 mm in anterior–posterior (AP), superior–inferior (SI) and medial–lateral (ML) directions, respectively. The average movements and standard deviations of the infraction bone structure movements were (mean ± SD): –0.91 ± 1.33 mm, –0.01 ±1.39 mm and –0.32 ± 1.46 mm in AP, SI and ML directions, respectively. The dominant intrafraction bone structure motions were in the AP and ML directions, while the dominant intrafraction prostate movements were in AP and SI directions. Conclusion: Based on the results we can conclude that a 3 mm extension of CTV–PTV margin, as the lower limit, is enough to ensure that 90% of the patients treated for prostate cancer will receive a minimum cumulative CTV dose higher than or equal to 95% of the prescribed dose, which is good. The reduction of the healthy margin size consequently leads to the potential reduction in the toxic load of the critical organs. Uvod: Vrednotenje intrafrakcijskih premikov karcinoma prostate v obsevalnem procesu, ki zajema spremljanje premikanja bolnika in notranjih organov, je običajen proces v klinični praksi, ki pomembno vpliva na določitev velikosti varnostnih robov. Namen: Namen raziskave je izboljšanje kvalitete obsevanja pri radikalnem obsevanju karcinoma prostate s pomočjo izračuna ustrezne velikosti varnostnega roba po Van Herkovi formuli. Metode dela: V raziskavo je bilo vključenih 9 bolnikov z radikalnim namenom zdravljenja karcinoma prostate. Vsi bolniki so bili obsevani z volumetrično modulirano ločno terapijo (VMAT) v kombinaciji z on-line slikovno vodeno radioterapijo (IGRT). Bolniki so imeli pred pričetkom obsevanja s pomočjo ultrazvoka v prostato vstavljena tri zlata zrna, ki omogočajo lokalizacijo prostate na elektronskem portalnem sistemu (EPID). Izračun populacijske (Σ) in naključne napake (σ) premikov je temeljil na slikanju pred in po končani dnevni obsevalni frakciji. Klinični tarčni volumen–planirani tarčni volumen (CTV–PTV), velikost ustreznih varnostnih robov, je bila izračunana po formuli Van Herka. Rezultati in razprava: Povprečni premiki in standardni odkloni intrafrakcijskega premikanja prostate so: –0,11 ± 1,79 mm, –1,07 ± 1,65 mm, –0,65 ± 1,56 mm v anteriornoposteriorni (AP), superiorno-inferiorni (SI) in medio-lateralni (ML) smeri, medtem ko povprečni premiki in standardni odkloni intrafrakcijskega premikanja kostnih struktur znašajo: –0,91 ± 1.33 mm, –0,01 ± 1,39 mm in –0,32 ± 1,46 mm prav tako v AP, SI in ML smeri. Intrafrakcijski premiki kostnih struktur so izrazitejši v AP in ML smeri, medtem ko so prevladujoči intrafrakcijski premiki prostate v SI in ML smereh. Zaključek: Rezultati so pokazali, da 3 mm velik varnostni rob od CTV do PTV zagotavlja, da 90% bolnikov v populaciji prejme 95% ali več predpisane minimalne kumulativne doze na CTV področje, kar je dobro. Zmanjšanje velikosti varnostnega roba posledično vodi do potencialnega zmanjšanja toksične obremenitve kritičnih organov. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: Slovenian refInfo: holdings: @attributes: islocal: N |
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